<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320089
Report Date: 09/03/2024
Date Signed: 09/03/2024 04:34:01 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
08/27/2024 and conducted by Evaluator Mario Leon
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20240827114916
FACILITY NAME:MERRILL GARDENS AT ROLLING HILLS ESTATESFACILITY NUMBER:
198320089
ADMINISTRATOR:TRACEY E HOLDERFACILITY TYPE:
740
ADDRESS:627 SILVER SPUR RDTELEPHONE:
(310) 974-3339
CITY:ROLLING HILLSSTATE: CAZIP CODE:
90274
CAPACITY:150CENSUS: 109DATE:
09/03/2024
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Tracey Mallaret, General ManagerTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not serve food of good quality
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 09/03/24 Licensing Program Analyst (LPA) Mario Leon conducted an initial, unannounced, complaint visit at the above-mentioned facility. LPA was met by Tracey Mallaret, General Manager (S1) and the purpose of the visit was explained. S1 and LPA toured the facility.
The investigation consisted of the following:
On 09/03/24 LPA requested and reviewed facility documents and toured the facility. LPA interviewed eleven (11) out of one-hundred and nine (109) clients and two (2) out of sixty-three (63) staff.
The investigation revealed the following: regarding the allegation, “Staff does not serve food of good quality”, it has been alleged that the food being served to residents always has the same taste.
Between 10:00AM and 10:45AM LPA received the monthly menu for August and the latest dietician's report, dated 07/11/24. Between 10:45AM and 3:00PM LPA interviewed eleven (11) residents and two (2) staff. Between 3:30PM and 5:00PM LPA wrote facilty report and conducted an exit interview with S1.
Report continues, see LIC9099C
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
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 11-AS-20240827114916
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: 09/03/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Interviews revealed that seven (7) out of 11 residents have disagreed with the allegation and agree that the food served is of good quality. Record reviews have shown appropriate, quarterly, visits have been done by a Dietician during meal service(s). Record reviews also show kitchen staff have completed food handling certification and have certificates on-site, conducted through premier food safety. 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.

An exit interview was conducted with Tracey Mallaret, General Manager, and a copy of this report has been provided.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2