198603331-10-31-2022-28-AS-LHIS-CLMP2Y-20221129095643

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603331
Report Date: 10/31/2022
Date Signed: 10/31/2022 03:25:48 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 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
10/21/2022 and conducted by Evaluator Jewel Baptiste

COMPLAINT CONTROL NUMBER: 28-AS-20221021152437

FACILITY NAME:	BRIGHT STAR ASSISTED LIVING		FACILITY NUMBER:	198603331
ADMINISTRATOR:	MARQUEZ, JOSE M		FACILITY TYPE:	740
ADDRESS:	9349 ROSE STREET		TELEPHONE:	(818) 642-3668
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	70	CENSUS: 50	DATE:	10/31/2022
		UNANNOUNCED	TIME BEGAN:	09:17 AM
MET WITH:	Administrator Luisa Mascardo		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Facility staff do not treat resident with respect
Facility staff yell at resident
Facility staff did not safeguard resident's personal property

INVESTIGATION FINDINGS:

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On 10/31/22 at 9:17 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced complaint investigation to the facility. Upon arrival, LPA met with staff #1 (S1) and explained the purpose of the visit. S1 contacted Administrator Luisa Mascardo via phone and LPA explained the reason for the visit. Administrator joined the visit at 10:00 a.m.

During today’s visit, LPA toured the facility with the S1 and obtained the resident/ staff roster and inservice trainings for residents personal rights. LPA reviewed the daily progress notes for R1, reviewed and obtained a copy of correspondence between case manager and administrator for R1, and a signed statement from R1 preventing staff from waking R1 for breakfast. LPA interviewed administrator, staff S1 through S3 and residents R1 through R5.

Report continued on 9099c

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Jewel Baptiste
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2022

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-20221021152437

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: BRIGHT STAR ASSISTED LIVING	FACILITY NUMBER: 198603331
	VISIT DATE: 10/31/2022

NARRATIVE

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The investigation reveals the following: Regarding "Facility staff do not treat resident with respect", it is alleged that R1 is being treated differently by S1. LPA interviewed administrator and confirmed that no resident complained about being disrespected by staff. 3/3 staff stated they have never disrespect the residents and have not witness other staff being disrespectful. 3/5 residents stated staff has never been disrespectful and it is usually the residents that disrespect the staff. 1/5 (R2) residents stated staff never disrespect them but has witness staff disrespecting another resident but is unsure of the name of the resident and staff. 1/5 (R1) residents stated that they felt like staff was treating them differently but since meeting with Case manger the staff has been nicer.

The investigation reveals the following: Regarding " Facility staff yell at resident", it is alleged that the S1 yells at R1. Administrator stated staff has never yelled at residents and no residents complained about staff. 3/3 staff stated they have not witnessed staff yelling at residents and have not heard residents complain about staff. 3/5 residents stated staff never yelled at them nor have they witness staff having those behaviors with other residents. 1/5 (R2) residents stated they have witness staff yelling at a resident but do not recall what was said, and who the resident or the staff were. 1/5 (R1) residents stated that staff yelled at them but now the staff has been nice.

The investigation reveals the following: Regarding " Facility staff did not safeguard resident's personal property", it is alleged that a caregiver put R1’s phone on silent to keep R1 from calling for assistance. Administrator stated there was one incident with a resident stating staff took their phone. The facility reviewed the camera for that day and confirmed no one entered the resident’s room. The administrator also stated staff assisted the resident in searching for the phone. The resident later found the phone in their personal property, but staff was not allowed to search the item the phone was found in during the initial search. 1/3 (S1) staff stated residents has complained about missing property and staff will assist them in searching for the missing item. Staff stated residents usually finding their missing property in their room. 2/3 staff stated they have not seen staff take residents belongings. 4/5 residents stated they have not had missing items since they moved in and do not hear other residents complain about missing items. 1/5 (R1) residents stated they were missing a phone and believe staff took and turned it on silent.

Based on LPA's interviews, investigation revealed: Although the allegation may have happened or is valid,

there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the
allegation is UNSUBSTANTIATED.

Exit interview conducted with Luisa Mascardo and a copy of this record provided.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Jewel Baptiste
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2022

LIC9099 (FAS) - (06/04)

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