198603331-1-23-2025-28-AS-RORN-DDUT8E-20250213133012

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603331
Report Date: 01/23/2025
Date Signed: 01/23/2025 04:33:46 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
01/15/2025 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250115120125

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: 65	DATE:	01/23/2025
		UNANNOUNCED	TIME BEGAN:	09:39 AM
MET WITH:	Silvia Vidal - Operation Manager		TIME COMPLETED:	04:46 PM

ALLEGATION(S):

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Staff did not address a resident's change in medical condition.
Staff did not properly dispose a needle.
Staff mishandled a resident's medication.
Staff served uncooked food to a resident.
Staff sexually harassed a resident while in care.
Staff unlawfully evicted a resident.
Staff mishandled a resident's personal belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced complaint visit to determine the validity of the above-mentioned allegations. LPA met with Silvia Vidal and explained the reason for the visit.

The investigation consisted of the following:
LPA obtained copies of the staff and resident rosters, reviewed R1's file and obtained copies of relevant documents, LPA toured medication room and reviewed 7 residnets medications, LPA toured kitchen and observed meal being served for lunch, and LPA interviewed 5 Staff (S1-S5) and 7 Residents (R1-R7).

(continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

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-20250115120125

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BRIGHT STAR ASSISTED LIVING	FACILITY NUMBER: 198603331
	VISIT DATE: 01/23/2025

NARRATIVE

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The investigation revealed the following:
Allegation: Staff did not address a resident's change in medical condition.
It is alleged that R1 sustained multiple falls at facility. LPA interviewed R1 and it was stated that they did sustained falls at facility and staff assisted them after their fall, they refused to be admitted to be sent to hospital for further treatment. LPA interviewed 5 staff and 5 out of 5 staff denied the above allegation and stated that when there are falls they tend to the resident immediately, offer check for bruising or cuts, offer if they would like to go to the hospital for further treatment, if they decline hospital they monitor the resident post fall, the fall is then documented and an incident report is filed. If there is a change in medical condition observed staff will ask resident if they would like to see a doctor to be assessed, if refusal staff will document changes and let their physician know of the changes with the resident. LPA interviewed 7 residents and 7 out of 7 residents denied the above allegation and stated that staff assists them in a timely manner with any medical needs.
Allegation: Staff did not properly dispose a needle
It is alleged that R1 fell and stepped on a needle after a nurse failed to dispose it correctly. LPA interviewed R1 and it was stated that the needle that they stepped on was in their room but did not show the staff the needle or get assistance from staff with this incident. LPA interviewed 5 staff and 5 out of 5 staff denied the above allegation and stated that all medications, including injections are kept in the medication room, administered in the medication room and have never seen any needles on the floor, all needles are disposed of in a specific box, which LPA also observed during visit. LPA interviewed 7 residents and 6 out of 7 residents denied the above allegation and stated that they have never seen a needle on the floor and confirmed all medication is given at the medication room.
Allegation: Staff mishandled a resident's medication
It is alleged that R1’s medication would frequently get mixed up with another resident’s. LPA toured medication room reviewed 7 residents medications with no issues observed. LPA interviewed 5 staff and 5 out of 5 staff denied the above allegation. S4 and S5 assist with administering medication and stated that they are careful with the medication to avoid situations like these, they also stated that although residents may sometimes question their medication they will take the resident to the medication room and show them the medication in original package to confirm medication is for the resident. LPA interviewed 7 residents and 6 out of 7 residents denied the above allegation stating that they have never had any issues with their medication.
(Continued on LIC9099-C)

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 28-AS-20250115120125

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BRIGHT STAR ASSISTED LIVING	FACILITY NUMBER: 198603331
	VISIT DATE: 01/23/2025

NARRATIVE

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Allegation: Staff served uncooked food to a resident
It is alleged that R1 was served uncooked food while living here that resulted in R1 getting sick multiple times. LPA toured kitchen and meal being served for day, the meat appeared to be well cooked. LPA interviewed 5 staff and 5 out of 5 staff denied the above allegation and stated that they have never had a resident complain that the food is uncooked and have not witnessed any residents getting sick from the food. LPA interviewed 7 residents and 6 out of 7 residents denied the above allegation and stated that although the chicken may be a little overcooked they have never observed it to be undercooked nor have they gotten sick from the food at the facility.

Allegation: Staff sexually harassed a resident while in care
It is alleged that R1 was sexually harassed by S1 and S2. LPA interviewed R1 and it was stated that S1 and S2 would try to hug and kiss R1, and that S1 would open the door to R1’s room at different hours of the night and watch R1 from the doorway. During interview with S3 it was revealed that the night shift does rounds every 2 hours, where they open the residents room door check to see the resident is present and will leave once they can confirm movement or that the resident is breathing, S3 also stated that they have never had any complaints against S1 and S2 of sexual harassment. LPA interviewed 5 Staff and 5 out of 5 staff denied the above allegation and stated that they have never sexually harassed a resident nor have they ever heard of another staff sexually harassing a resident. LPA interviewed 7 residents and 6 out of 7 residents denied the above allegation stating they have never been sexually harassed by staff.

Allegation: Staff unlawfully evicted a resident
It is alleged that R1 was not given proper notice that they were going to be forced to leave facility after R1 was hospitalized. During interview with S3 it was explained that R1 was hospitalized on a psychiatric hold, once released from the hospital the facility was notified that the resident was going to be transferred to a different facility, S3 spoke with family of R1 and it was confirmed that R1 will be moving to a facility closer to them, R1 was never evicted from facility. LPA interviewed 5 staff and 5 out of 5 staff denied the above allegation and confirmed that residents are given warnings prior to any evictions and have never witnessed an unlawful eviction. LPA interviewed 7 residents and 6 out of 7 residents denied the above allegation and stated that although they haven’t been evicted they have not witnessed another resident be evicted without reason.
(Continued on LIC9099-C)

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 28-AS-20250115120125

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BRIGHT STAR ASSISTED LIVING	FACILITY NUMBER: 198603331
	VISIT DATE: 01/23/2025

NARRATIVE

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Allegation: Staff mishandled a resident's personal belongings
It is alleged that R1 was never given an opportunity to properly pick up their belongings and when R1 went to collect their belongings everything was in the front of the street, with items missing. LPA interviewed 5 staff and 5 out of 5 staff denied the above allegation stating that residents items are typically packed and stored in the storage room for at least 30 days to allow residents to collect their items. LPA interviewed S4, who assisted R1 with gathering their belongings and it was stated that R1s items were stored in the storage room near administrative office and R1 collected their items with no issues that day, R1’s items were never placed on the street. LPA interviewed 7 residents and 6 out of 7 residents denied the above allegation and stated that they have never witnessed any residents belongings on the street and feel staff handle their personal items with care.

Based on statements and interviews conducted with staff/residents, review of R1's file and observations made during facility tour, there was not enough supportive evidence to concur with the reported allegations. 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 allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report will be emailed to Silvia Vidal at brightstarassistedliving@gmail.com.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

LIC9099 (FAS) - (06/04)

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