198602216-10-14-2021-11-AS-MCAA-C8KSKP-20211108125704

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602216
Report Date: 10/14/2021
Date Signed: 10/14/2021 02:01:35 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/31/2021 and conducted by Evaluator Jennifer Jones

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20210831155418

FACILITY NAME:	FRANCESCA'S HOME		FACILITY NUMBER:	198602216
ADMINISTRATOR:	COELLO, BESSIE L		FACILITY TYPE:	740
ADDRESS:	20520 AVIS AVENUE		TELEPHONE:	(310) 292-8425
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90503
CAPACITY:	6	CENSUS: 6	DATE:	10/14/2021
		UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Bessie Coello, Licensee		TIME COMPLETED:	02:25 PM

ALLEGATION(S):

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Facility failed to provide a safe environment for residents in care
Untrained staff
Facility allowed uncleared adult to work at the facility

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Jennifer Jones and Ngozi Nwaokoro conducted a subsequent complaint visit and delivered findings for the allegations listed above. Upon arrival, LPAs were greeted by Licensee, Bessie Coello and the reason for the visit was explained.

On 09/02/21, LPA toured the entire facility inside and outside including medication storage room, interviewed the administrator, staff 2 , residents 1-3 and attempted to interview residents 4 and 5 about the allegations. LPA requested and received copies of resident and staff rosters and copies of staff personnel records, criminal record clearances and medication training for staff who worked in the facility in the past 60 days.

On 09/24/21, LPA Jones conducted a visit and requested resident medication logs for August 2021.
On 10/08/21, LPAs Jones and Nwaokoro met with Licensee and staff and requested the glucose logs for residents in care and staff medication training for former employees. During the visit, staff 2 gave LPAs a verbal explanation own how she assist residents with medication and glucose checks.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Jennifer Jones
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20210831155418

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: FRANCESCA'S HOME	FACILITY NUMBER: 198602216
	VISIT DATE: 10/14/2021

NARRATIVE

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On 10/14/21, LPA Jones delivered findings.

The allegation revealed the following. For allegation:(Facility failed to provide a safe environment for residents in care.) It is being alleged that the medication cabinet at the facility was always unlocked and the medications were accessible to the residents. During the visit on 09/02/21, LPA toured the facility and observed the medication storage room. LPA Jones observed the medication storage room locked and asked staff to get the key to open it. During the visit LPA interviewed the licensee, staff 2, residents 1-3 and attempted to interview residents 4 and 5 about the allegation. The licensee stated that she keeps the medication storage room locked and requires all of the staff to keep the room locked as well. Staff 2 revealed during her interview that she keeps the room locked at all times and keeps the key in pocket during her shift. Resident 1-3 said they do not know if the room is locked or not. Residents 1-3 stated that they do not go into the medication storage room. Residents 4 and 5 were unable to answer LPA's question due to medical diagnosis.

For allegation: (Untrained staff). It is being alleged that the facility is allowing untrained staff to administer medication. LPA Jones interviewed the licensee about the allegation. The licensee revealed during her interview that all of her staff receive medication training before administering it to residents. The licensee provided LPA with copies of staff training on medication procedures for all of her staff including the staff who worked for the facility temporarily. Staff 2 revealed during her interview that when the facility has new staff, she will allow them to observe her but she will not allow them to administer medication. Staff 2 stated that she is not aware of any staff who administered medication without being trained. Staff 2 gave LPA a verbal and live demonstration on how she assist residents with medication and glucose checks. LPA interviewed resident 1- 3 and asked the residents if they knew the alleged untrained staff. Residents 1-3 stated they receive medications daily but didn't remember the staff LPA mentioned. Residents 4 and 5 were unable to answer LPA's question due to medical diagnosis.

For allegation: (Facility allowed uncleared adult to work at the facility.) It is being alleged that the facility hired new staff to work for the facility without being finger print cleared. LPA interviewed the licensee about the allegation. The licensee denied the allegation and provided LPA with a staff roster for the months of July 2021-September 2021 with all of the finger print clearances. Staff 2 stated that she doesn't know anything about the fingerprint clearances because she doesn't work with the administrative part of the facility. S2

SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Jennifer Jones
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20210831155418

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: FRANCESCA'S HOME	FACILITY NUMBER: 198602216
	VISIT DATE: 10/14/2021

NARRATIVE

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stated that her job is direct care only. Residents 1- 3 stated that all of the caregivers are nice and they did mention any new staff that assisted them. Residents 4 and 5 were unable to answer LPA's question due to medical diagnosis.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted an a copy of the report was given to the licensee

SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Jennifer Jones
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

LIC9099 (FAS) - (06/04)

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