Senior Care Records.

Complaint Investigation Report

Pasadena Villa Senior Living, Pasadena01/12/2024Licence 198603286

Census75
Date signed01/12/2024 03:29:15 PM
Name of licensing program analystLuis Mora
Name of licensing program managerWei Siew Ho
The inspector’s account

The investigation revealed the following: regarding the allegation "facility staff are not properly addressing pest infestation in facility", it is alleged that on 12/13/2023 cockroaches were observed in the kitchen of the facility and a dried maggot on the soda machine dispenser spout. Assistant Administrator and 3 staff denied the allegation and stated that pest control comes on a monthly basis. The complainant stated that they asked a staff to dispose of the cockroaches that they found which were alive. LPA interviewed this staff and confirmed the complainant's statement to be true. LPA observed monthly pest control invoices dating back to October 2023. However, LPA contacted the pest control company and stated that in the last 3 months they have only service the outside of the building. They only do the inside of the facility if it requested by the facility. Per their records, there was a request made to conduct pest control services inside the facility and it was scheduled for 12/18/2023 at night, but they were unable to conduct this service because they were not able to get inside the kitchen. Pictures and videos of alive cockroaches in the kitchen were submitted to the Community Care Licensing Division (CCLD) along with this complaint. A picture of the soda machine dispenser spout showing what appears to be a dried maggot was also submitted. On 12/21/2023, LPA observed dead cockroaches in the kitchen and could not identified whether the soda machine dispenser spout had a dried maggot or dried syrup. However, the soda machine dispenser spout did appear to be unsanitary and this will be cited on a separate report. Four of the residents interviewed stated that they have seen cockroaches in either their rooms or hallway.

Regarding the allegation " facility staff are not addressing tripping hazards on the facility floor ", it is alleged that there are pieces of the flooring that are lifted in multiple locations around the facility. On 12/21/2023, LPA observed floor tile lifting in the dining room and loose/damaged floor tile in room #23. During today's visit, the Assistant Administrator stated that the flooring tile in the dining room has been fixed and LPA confirmed. The floor tile in room #23 still needs repair.

Regarding the allegation " facility staff are not providing residents with furniture that is in good repair ", it is alleged that in room #23 and #46 both of the residents' dressers were broken into pieces and in room #40 the dresser and table were broken and not able to be used properly. On 12/21/2023, LPA observed that room #40 one of the dresser's drawer was broken into pieces and the table was in good condition. In room #46 one of the drawers of the dresser is loose and it is not sliding in or out properly. LPA did not observed any damage to the furniture in room #23 and confirmed with the resident in that room.

Based on observation, record review and interviews conducted, the preponderance of evidence standard has been met, therefore the allegations are found SUBSTANTIATED. California Code of Regulations Title 22, Division 6, and Chapter 8 are being cited on the attached LIC 9099-D.

Exit interview held and a copy of the report and appeal rights was provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction