State Officials Come Calling Unannounced at Care Homes

The elderly, white-haired woman stood in the family room of a home on Patricia Drive in Garden Grove, trembling with what clearly was fear.

“I don’t want to complain,” she whispered. “It makes it harder on us. But if would be nice if we got more to eat.”

The house in which the woman lives was one of six residential board-and-care homes for the elderly in Orange County that were visited Thursday by members and staff of the Commission on California State Government Organization and Economy, a state watchdog agency commonly known as the Little Hoover Commission.

The occasion was the beginning of the commission’s second study in five years of board-and-care homes in California, some of whose operators have totally ignored efforts to get them to comply with health and safety regulations, state and county officials said Thursday. Once the study is complete, perhaps as early as September, a report will be submitted to the Legislature.

The first public hearing in the commission’s new study will be held today from 9:30 a.m. to 2 p.m. at the Hall of Administration in Santa Ana.

The commission chose Orange County as the site of its unannounced visits and the first of two public hearings after the Orange County Grand Jury asked it to look into complaints that surfaced in a grand jury inquiry that began last year.

Commission and county officials say there is a statewide boom in the lucrative board-and-care industry that is particularly evident in Orange County. There are more than 340 licensed board-and-care homes in the county, and an undetermined number of unlicensed ones.

Licensed homes are regulated by the state Department of Social Services. Operating an unlicensed home can lead to a maximum fine of $1,000.

Most of the complaints about board-and-care homes received by the state, officials said, have to do with lack of food and mishandling of medications, but some involve physical and sexual abuse of residents and even deaths.

The worst of the facilities, said Little Hoover Commission Chairman Nathan Shapell, are little more than “warehouses for the dying,” where residents pay as much as $2,500 a month in rent.

Jean Kindy Walker, who sits on a 30-member advisory committee that was formed by the Little Hoover Commission for the new board-and-care study, called the situation a travesty.

“Many of the licensed homes are bad,” said Walker, “so you can imagine what goes on in the ones that operate underground.”

Orange County Grand Jury members heard horror story after horror story when they began to make inquiries into the matter, said Judy Sisneros, a grand juror who also sits on the Little Hoover Commission advisory committee.

“The grand jury before us had been looking into board and care toward the end of its term but didn’t have time to finish,” Sisneros said. “They suggested that we look at it, as well, and we did.”

The grand jury went to the Little Hoover Commission because the state, not the county, regulates board-and-care homes, she said.

Walker said she was certain that some of the operators of the homes toured in Santa Ana, Costa Mesa, Buena Park and Garden Grove on Thursday had somehow learned of the unannounced visits and had gone into a frenzy of cleaning.

Walker said similar Little Hoover Commission visits to board-and-care homes around the state five years ago--sometimes in the middle of the night without notifying local authorities or the media--turned up horrible examples of neglect and abuse.

“When we did our report in 1983, things cleaned up for a while,” Shapell said. “But after a couple of years, they’ve gotten lax again.”

Shapell and Walker said the biggest barriers to correcting or shutting down problem homes are weak enforcement regulations and poor coordination among agencies.

“The most that can happen to an operator,” Walker said, “is a $50 fine that half of them don’t even bother to pay.”

Shapell was critical of families that “dump” elderly members in board-and-care homes and do not monitor how they are treated.

John Grant, a county Social Services Agency official who was on the tour Thursday, said that in Orange County, monitoring of homes by the Department of Social Services licensing inspectors is hampered by their workloads. Each of the six inspectors assigned to board-and-care homes in the county has about 60 facilities to monitor, Grant said. During the visits Thursday, officials said there were indications of problems everywhere.

Expressions of Anger

The complaint of hunger from the woman at the Garden Grove home brought expressions of anger and dismay from commission members who had trooped through the poorly kept facility a few minutes earlier. Bedrooms were unkempt, and a foul-smelling kitchen was filled with dirty dishes and garbage.

At the 55-bed Artesia Gardens Guest Home in Buena Park, sometimes overpowering smells of urine lingered near bedrooms and bathrooms. At one point the tour group--including male reporters and photographers--observed, through a wide open bathroom door, an old woman in a state of undress as a male attendant helped her use a toilet.

At the same home, pillows covered with plastic had no pillow cases, and a key had been left in the lock of a drawer containing medication. Slices of ham being prepared as part of the residents’ lunch were so thin you could see through them.

Grant said almost every board-and-care home is cited for a violation of state regulations at some time. But some, he said, commit violations repeatedly.

Two homes in Buena Park operated by Ruth Woodrum have been cited a total of 12 times since June 10, according to the commission staff.

Woodrum said during a tour of her home Thursday that all the violations involved mishandled paper work. Documents distributed by the commission staff, however, showed a citation against Woodrum last year involving a resident being tied to her bed.

Officials agreed that the worst home on the tour list, by far, was the Kamphuis Small Family Home in Garden Grove.

Pamala D. McGovern, executive director of the Orange County Council on Aging’s Long-Term Care Ombudsman Services, said that in December, 1986, she went to the home and found it crawling with ants and roaches.

On Thursday there were no ants or roaches, but the home was so filthy that Grant telephoned an inspector and directed her to come there. Walker insisted that a lock on the outside of a bedroom door be removed immediately.

“If I were inspecting you, I’d cite you on the spot,” he told Jeanne Kamphuis, the home’s operator.

Mary Kaarmaa, contacted later at the Department of Social Services office in Santa Ana, said an inspector had been sent to the home and would write a report today.

Some of the workers and operators at homes visited Thursday seemed amused by the tour. Some were angered by it. None, however, refused entry to the state officials and Grant, who as a licensing official can enter the facilities at any time.

Yoram Monrof, who with his wife, Lilia, operates Artesia Gardens, called the surprise visits unfair but cooperated with requests from the officials that doors and cabinets be unlocked while they were shown about.