198320089-1-13-2026-11-AS-UCOL-DSGLNW-20260324085501

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320089
Report Date: 01/13/2026
Date Signed: 01/13/2026 03:01:39 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/02/2025 and conducted by Evaluator Mario Leon

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20251002131508

FACILITY NAME:	MERRILL GARDENS AT ROLLING HILLS ESTATES		FACILITY NUMBER:	198320089
ADMINISTRATOR:	TRACEY E HOLDER		FACILITY TYPE:	740
ADDRESS:	627 SILVER SPUR RD		TELEPHONE:	(310) 974-3339
CITY:	ROLLING HILLS	STATE: CA	ZIP CODE:	90274
CAPACITY:	150	CENSUS: 106	DATE:	01/13/2026
		UNANNOUNCED	TIME BEGAN:	09:09 AM
MET WITH:	Tracey Mallaret - Executive Director		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Facility does not employ sufficient staff to meet residents needs.
Staff does not ensure that resident's hygiene needs are being met.
Staff does not ensure that resident's dental hygiene needs are being met.

INVESTIGATION FINDINGS:

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On 01/13/26 Licensing Program Analyst (LPA) Mario Leon conducted a subsequent complaint visit at the facility. LPA was met by staff one, Tracey Mallaret - General Manager (S1) and the purpose of the visit was explained.
The investigation consisted of the following:
On 10/08/25 LPA requested and received the following documents: resident and staff rosters, staff schedule for the months of September and October of 2025 (09/25 & 10/25). LPA also requested six (6) resident documents (R1-R6), listed as follows: face sheets (emergency ID) (dated: varioius), physician reports (LIC602a) (dated:various), needs and services plan (dated: various) and care logs of 6 residents in care. LPA interviewed six (6) residents (R1 through R4 & R6), R5 is non-verbal and therefore LPA was unable to interview R5, and two (2) staff (S1-S2). On 01/13/26 LPA interviewed three (3) staff (S3-S5) and conducted further record review.

Report continues, please see LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2026

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 11-AS-20251002131508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: MERRILL GARDENS AT ROLLING HILLS ESTATES	FACILITY NUMBER: 198320089
	VISIT DATE: 01/13/2026

NARRATIVE

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The investigation revealed the following:
Regarding the allegation "Facility does not employ sufficient staff to meet residents needs.", it has been alleged that there is only one (1) caregiver per twenty (20) residents. Interviews revealed that all five staff (S1-S5) and all five residents (R1-R5) have not agreed the allegation has taken place. Record reviews revealed staff coverage for residents in care, between the months of September and October of 2025 (09/25 & 10/25), are within Title 22 regulation. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.
Regarding the allegation "Staff does not ensure that resident's hygiene needs are being met.", it has been alleged that staff are not assisting residents with their Activities of Daily Living (ADL). Interviews revealed that all five staff (S1-S5) and all five residents (R1-R5) have not agreed the allegation has taken place. Record reviews revealed that residents' care plan and service logs align and no discrepancies were observed. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.
Regarding the allegation "Staff does not ensure that resident's dental hygiene needs are being met.", it has been alleged that a resident suffered from tooth decay, resulting in a broken tooth. Interviews revealed that all five staff (S1-S5) and all five residents (R1-R5) have not agreed the allegation has taken place. Record reviews revealed that for residents' care plan indicating full-assist with brushing teeth do match their service logs. Furthermore, staff have indicated that they can easily tell those who have not brushed their teeth and when noticed, prompting and assisting with brushing has become the normal pattern. Based on record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

There have been zero (0) deficiencies cited during today's visit.

An exit interview was held with staff one, Tracey Mallaret - General Manager

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2026

LIC9099 (FAS) - (06/04)

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