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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306001252
Report Date: 01/18/2023
Date Signed: 01/20/2023 03:51:57 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/04/2022 and conducted by Evaluator Michelle Reed
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20221104112904
FACILITY NAME:BUBBE & ZAYDE'S PLACE IIFACILITY NUMBER:
306001252
ADMINISTRATOR:CURKIN, BONNIEFACILITY TYPE:
740
ADDRESS:1533 E. 20TH ST.TELEPHONE:
(714) 542-3939
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY:6CENSUS: 5DATE:
01/18/2023
UNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Seth CurkinTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff yell at residents
Staff leave resident in bed all day
Staff are not providing adequate activities for resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst Michelle Reed arrived at the facility to deliver the findings of this complaint investigation. Upon arrival, LPA met with Seth Curkin. The complaint was investigated and consisted of interviews with the facility staff, Administrator and residents. The following was determined:

On 11/4/22, an initial visit was conducted at the facility. On that day, LPA toured the facility and interviewed residents and staff present. Records were also reviewed. LPA interviewed three out of five residents. Residents stated that there are activities offered but sometimes they prefer not to participate. The fourth and fifth resident had cognitive impairment and could not be interviewed. Two of five residents interviewed stated that staff speak nicely to them and treat them well and they have not heard staff yelling.

Random staff were also interviewed and disclosed that they have not heard any staff yelling at residents. Activities are provided everyday by the facility staff but some of the residents even though encouraged, choose to stay in bed and watch tv, read or crochet.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Michelle Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 22-AS-20221104112904
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: BUBBE & ZAYDE'S PLACE II
FACILITY NUMBER: 306001252
VISIT DATE: 01/18/2023
NARRATIVE
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 Based upon interviews conducted and records reviewed, the allegations are unsubstantiated, meaning that although the allegations may have happened there is not a preponderance of the evidence to prove that resident rights are being violated..

An exit interview was conducted with and a copy of this report was provided to Seth Curkin.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Michelle Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2