198602557-3-15-2024-28-AS-LHIS-D4CLKZ-20240415085020

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602557
Report Date: 03/14/2024
Date Signed: 03/15/2024 08:26:09 AM

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/08/2024 and conducted by Evaluator Nicol Wesley

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240308153616

FACILITY NAME:	ALONDRA GUEST HOME		FACILITY NUMBER:	198602557
ADMINISTRATOR:	VILLAFLORES, LOURDES		FACILITY TYPE:	740
ADDRESS:	11849 ALONDRA BLVD		TELEPHONE:	(562) 863-7630
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	6	CENSUS: 5	DATE:	03/14/2024
		UNANNOUNCED	TIME BEGAN:	10:33 AM
MET WITH:	Joy Villaflores		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff do not respond to resident's requests for assistance in a timely manner.
Staff leave resident in soiled condition for an extended period of time.
Staff do not treat resident with respect.

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Nicol Wesley conducted an unannounced 10 day complaint visit at the facility and met with Administrator Joy Villaflores to discuss the purpose for todays visit.

During the visit, LPA Wesley requested a copy of the staff and resident roster,toured the residents rooms, interviewed the residents, and request copies of specific documents.

Regarding allegation- Staff do not respond to resident's requests for assistance in a timely manner. LPA Wesley interviewed 4 out of 5 residents who incated that staff responds to them in a timely manner when they are called. The 5th resident is can not be interviewed, they cant speak and is on hospice.

Continued LIC 9099C.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Nicol Wesley
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024

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 28-AS-20240308153616

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: ALONDRA GUEST HOME	FACILITY NUMBER: 198602557
	VISIT DATE: 03/14/2024

NARRATIVE

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Regarding allegation- Staff leave resident in soiled condition for an extended period of time. LPA interviewed 4 out of 5 residents who indicated staff does not leave them in a soiled condition for an extended period of time. The 5th resident can not be interviewed, they cant speak and are on hospice. LPA Wesley interviewed the administrator who said resident #1 has an overactive bladder and They went without medication because they canceled their 02/26/24 appointment and the prescriptions were non refillable. Administrator also stated resident #1 enjoys staying outside in the backyard area so they can smoke and when they try to change resident #1, they'll say wait a minute, I'm not done smoking. Administrator also indicated that Resident #1 is always worried about soiling up their diapers and say I only urinated twice, and doesn't want to be changed.

Regarding allegation- Staff do not treat resident with respect. LPA Wesley interviewed 4 out of 5 residents who said the staff treats them with respect, resident #3 said if they didn't, I know what to do. The 5th resident can not be interviewed, they cant speak and are on hospice.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED. A copy of the LIC 9099, LIC 9099C was given during the exit interview.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Nicol Wesley
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024

LIC9099 (FAS) - (06/04)

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