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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320131
Report Date: 05/02/2025
Date Signed: 05/02/2025 05:44:15 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/18/2024 and conducted by Evaluator Wendy Gibbs
COMPLAINT CONTROL NUMBER: 11-AS-20240318132553
FACILITY NAME:SILVERADO ROLLING HILLSFACILITY NUMBER:
198320131
ADMINISTRATOR:LOURDES MENCHACAFACILITY TYPE:
740
ADDRESS:2455 PACIFIC COAST HWYTELEPHONE:
(424) 488-0593
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY:68CENSUS: 41DATE:
05/02/2025
UNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Taylor GiuntoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff left resident in wet clothing for extended periods
Staff mismanaged residents medication
Untrained staff
Resident are being neglected while in care
Staff don't answer facility phone
Staff did not assist resident in a timeley manner
Facility doesn't have an administrator
Staff did not ensure residents have their meals in a timely manner
Staff did not provide a safe environment for residents
INVESTIGATION FINDINGS:
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On 05/02/2025 the department conducted an unannounced subsequent complaint visit. During today’s visit the department toured the facility and delivered findings for the complaint listed above.
The investigation consisted of the following:
During the initial visit, conducted on 3/27/2024, the department toured the facility, interviewed Staff (S2-S12) interviewed Residents (R1-R6), interviewed Residents Responsible Party (W1-W5), and received documents pertinent to the investigation. The documents received include Staff Roster, Resident Roster, Staff Training Logs, Incontinent Resident List, resident eMAR (electronic Medication Administration Record), Room Cleaning Schedule, Change of Administrator Letter, updated LIC 308 (Designation of Facility Responsibility), Board of Directors Resolution letter, Residential Care for the Elderly Administrator Certificate which expires on 10/20/24, resume, LIC 501 (Personnel Record), current LIC 503 (Health Screening),valid CPR and First Aid training which valid till 09/19/25, Driver’s License, updated LIC500 (Personnel Report), updated LIC610E (Emergency and Disaster Plan), and Criminal Background Clearence.
The investigation revealed the Following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
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 10
Control Number 11-AS-20240318132553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SILVERADO ROLLING HILLS
FACILITY NUMBER: 198320131
VISIT DATE: 05/02/2025
NARRATIVE
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Allegation: Staff left resident in soaking wet clothing for extended periods
The details of the complaint alleged that facility staff are leaving residents in soaking wet clothing for extended period of time.
During the records review, LPA received and reviewed the Resident Incontinent List and reviewed Resident Physician’s Report, Pre-Admission Appraisal, Needs and Service Plans, Staff Notes for the past 5 months and Admission Agreement.
During interviews with staff (S2-S12), were asked if a resident has been left in soiled diapers or clothing for an extended period of time, eleven (11) out of eleven (11) stated they have not seen nor heard of any residents being left in soiled diapers or clothing for an extended period of time. Additionally, staff S2-S12 were asked how often incontinent residents are changed, nine (9) out of eleven (11) stated they are checked every two hours, one stated when needed, and one stated on a regular basis.
During interviews with residents (R1-R6), were asked if they have been left in soiled diapers or clothing for an extended period of time, five (5) out of six (6) stated they have not been left in soiled diapers or clothing for an extended period of time and they are assisted right away.
During the visit, the department interviewed five (5) family members of residents living in the facility (spouse or children). During interviews with witnesses W1-W5, were asked if there has been a time their family had been left in soiled diapers or clothing for an extended period of time, four (4) out of five (5) stated they have not been told or observed their family being left in soiled diapers or clothing. One witness stated that was an issue they experienced 5 months ago, and there have been no issues with it recently.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.


Allegation: Staff mismanaged residents’ medication
The details of the complaint alleged that facility staff have given the wrong medication to residents.
During the records review, LPA reviewed the facility’s electronic Medication Administration Record (eMAR) and compared it to the centrally stored medications for 10 residents. LPA observed ten (10) out of ten (10) resident’s eMARs and medications are consistent with properly documented records. LPA reviewed Special Incident Reports (SIR) submitted since October 1, 2023, and did not observe any SIRs reporting a medication errors.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 10
Control Number 11-AS-20240318132553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SILVERADO ROLLING HILLS
FACILITY NUMBER: 198320131
VISIT DATE: 05/02/2025
NARRATIVE
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During an interview with staff S10, was asked if residents receive their medications as prescribed, S10 stated residents are given their medications as prescribed. Additionally, S10 was asked if there were any medication errors in the past two (2) months and S10 stated, to their knowledge there have been no medication errors.
During interviews with staff S2-S9 and S11-12, were asked if residents receive their medications as prescribed, ten (10) out ten (10) stated as far as they know residents receive their medications as prescribed.
During interviews with residents (R1-R6), were asked if they receive their medications as prescribed, six (6) out of six (6) stated yes, they receive their medications as prescribed.
During interviews with Witnesses W1-W5, were asked if their family in the facility receive their medications as prescribed, four (4) out of five (5) stated yes, their family receives medications as prescribed. One (1) witness stated it was an issue in the past, but they have not had a problem in a long time, and it has been good.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.


Allegation: Untrained staff
The details of the complaint alleged that facility staff are untrained and administering medication.
During the records review, LPA reviewed the training records for six (6) staff including two (2) med techs. LPA observed staff had over the hours of training required. Additionally, LPA received and reviewed In-Service logs conducted monthly and attended by all staff. LPA observed In-Services were conducted on all shifts so staff could attend. LPA observed Nurses have additional in-services for just them and their position.
During interviews with staff (S2-S12), were asked if they are provided with regular training and in-services, eleven (11) out of eleven (11) stated they receive regular annual training on Relias and in-services are conducted a minimum of once a month, if not more.
During interviews with residents (R1-R6), were asked if they have any concerns regarding staff training, six (6) out of six (6) stated they have no concerns regarding staff training. Additionally, three (3) stated the staff are good and do a great job.
During interviews with Witnesses W1-W5, were asked if they have any concerns regarding staff training, five
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 10
Control Number 11-AS-20240318132553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SILVERADO ROLLING HILLS
FACILITY NUMBER: 198320131
VISIT DATE: 05/02/2025
NARRATIVE
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(5) out of five (5) stated they have no concerns regarding staff training.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.


Allegation: Residents are being neglected while in care
The details of the complaint alleged that the facility has insufficient staffing to meet the needs of the residents.
During the records review, LPA received and reviewed a copy of the staffing schedule and observed there are four (4) caregivers, and two (2) nurses on during the day and evening shift, and for the Noc shift there are three (3) caregivers and a nurse on shift.
During interviews with staff (S2-S12), were asked if they feel the facility is sufficiently staffed, eleven (11) out eleven (11) stated yes, they are sufficiently staffed.
During interviews with residents (R1-R6), were asked if there are enough staff to provide assistance to residents, six (6) out of six (6) stated that yes, there is enough staff to provide assistance to residents.
During interviews with Witnesses W1-W5, were asked if they feel there is enough staff to provide assistance to residents, three (3) out of five (5), stated yes there is enough staff to provide care.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.


Allegation: Staff don’t answer facility phone
The details of the complaint alleged that facility staff fail to answer facility phone.
During the records review, LPA reviewed Special Incident Reports (SIR) to see if there was any notification of the facility not having phone service, LPA did not observe any report. During the facility visit, LPA called the phone number posted on the door and the phone was answered right away by staff.
During interviews with staff (S2-S12), was asked if there is someone responsible for answering phones throughout the day, eleven (11) out eleven (11) stated that yes, the phones are answered at the front desk throughout the day and in the evening the phones are transferred to the nurse’s station. Additionally, three
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 10
Control Number 11-AS-20240318132553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SILVERADO ROLLING HILLS
FACILITY NUMBER: 198320131
VISIT DATE: 05/02/2025
NARRATIVE
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(3) staff stated that for some time the company’s main phone number, and not the facility number, was posted on the door.
During interviews with Residents R1-R6, were asked if them or their family have called the facility phone and their phone call was not answered, six (6) out of six (6) stated no, they have there is always someone there.
During interviews with Witnesses W1-W5, were asked if they have called the facility and their phone call was not answered, five (5) out of five (5) stated when they call the facility phone is answered.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.


Allegation: Staff did not assist residents in a timely manner
The details of the complaint alleged that when residents require assistance, they call for staff, but either the staff do not show up or respond very late.
During the facility inspection, LPA tested the call buttons in rooms 105,106,109, and 217. Caregivers responded to the pendants call for assistance in under 8 minutes.
During an interview with Staff (S2-S12), were asked if any residents had to wait an extended period of time before receiving assistance, eleven (11) out of eleven (11) stated no residents have not had to wait an extended period of time for staff to provide assistance.
During interviews with Residents R1-R6, were asked if when they press the pendant for assistance if they have had to wait an extended period of time for assistance, four (4) out of six (6) stated they have not had to wait long for assistance from staff. Additionally, two (2) out of six (6) stated they do not require assistance.
During interviews with Witnesses W1-W5, were asked if their resident has had to wait for an extended period of time for assistance, five (5) out of five (5) stated to their knowledge they have not had to wait an extended period of time.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 10
Control Number 11-AS-20240318132553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SILVERADO ROLLING HILLS
FACILITY NUMBER: 198320131
VISIT DATE: 05/02/2025
NARRATIVE
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Allegation: Facility doesn’t have an administrator
The details of the complaint alleged that the facility currently lacks an administrator.
During the record review, LPA received a copy of the change of administrator packet that was mailed to the Community Care Licensing (CCL) on March 21, 2024. The packet consisted of Change of Administrator Letter, updated LIC 308 (Designation of Facility Responsibility), Board of Directors Resolution letter, Residential Care for the Elderly Administrator Certificate which expires on 10/20/24, resume, LIC 501 (Personnel Record), current LIC 503 (Health Screening),valid CPR and First Aid training which valid till 09/19/25, Drivers License, updated LIC500 (Personnel Report), updated LIC610E (Emergency and Disaster Plan), and Criminal Background Clearence.
During an interview with Staff S2 stated the documents were recently sent into CCL. S2 stated S1 is a travel administrator for the company. S1 will go to a facility and help train the future administrator which will be S2.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.


Allegation Staff did not ensure resident have their meals in a timely manner
The details of the complaint alleged in the memory care unit residents are to receive their meals promptly, but staff fail to provide them with meals in a timely manner.
During the record review, LPA received and reviewed the dining schedule posted for meals. LPA observed a schedule for meals posted in the dining rooms, breakfast is served at 8:00 AM, Lunch is served at 11:30 AM, and dinner is served at 4:30 PM. During the facility visit, LPA observed lunch being served on the two floors. LPA observed lunch being served on the first floor, residents began sitting in the dining area at 11:20 AM to 11:30 AM, many came from an activity. LPA observed at 11:34 AM, staff began giving residents soup and salad, beverages and then lunch was provided. LPA went to the second floor at 11:53 AM and observed residents on the second floor eating their lunch.
During an interview with Staff (S2-S12), were asked if residents are served their meals in a timely manner, eleven (11) out of eleven (11) stated yes, resident’s meals are provided in a timely manner.
During interview with Residents R1-R6, were asked if they receive their meals in a timely manner, six (6) out of six (6) stated yes, they receive their meals in a timely manner.
During interviews with Witness W1-W5, were asked if their resident receives their meals in a timely manner, five (5) out of five (5) stated yes, their resident receives their meals in a timely manner. Additionally, one stated the longest they have seen residents wait for their food was five (5) minutes.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 10
Control Number 11-AS-20240318132553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SILVERADO ROLLING HILLS
FACILITY NUMBER: 198320131
VISIT DATE: 05/02/2025
NARRATIVE
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During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.
Allegation: Staff did not provide a safe environment for residents
The details of the complaint alleged that no staff are present on the premises to assist residents and that cleaning materials are left out for the residents to access.
During tour of the facility, LPA did not observe any chemicals accessible to residents. LPA did observe the storage rooms where chemicals are stored and to gain access to it you must go through three locked doors, that require an access code. LPA observed an empty bottle of disinfecting wipes in a high locked cabinet in the Bistro area. LPA inspected housekeeping cart to observe how chemicals are stored and kept inaccessible to residents.
During the record review, LPA received and reviewed training logs regarding safety that were conducted on 04/25/2024 with the topic of Resident Safety and Security, 04/22/2024 with the topic of Caregiver Check and Account for all Residents, and on 02/20/2024 with the topic of Housekeeping Carts.
During an interview with Staff (S2-S12), were asked if they have observed or heard of cleaning product being left out and accessible to residents, eleven (11) out of eleven (11) stated they have not seen cleaning products left out.
During interview with Residents R1-R6, were asked if they have observed cleaning products left out in the facility, six (6) out of six (6) stated no, they have not seen cleaning products left out in the facility. Additionally, residents were asked if they feel safe living in the facility, six (6) out of six (6) stated yes, they feel safe living in the facility.
During interviews with Witness W1-W5, were asked if they have observed cleaning products left out around the facility, five (5) out of five (5) stated no, they have not seen cleaning products left out in the facility. Additionally, they were asked if they have any concerns regarding their resident’s safety, five (5) out of five (5) stated they believe their residents are safe living at the facility.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.


An exit interview was conducted with Administrator, Taylor Giunto, and a copy of this report was provided.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/18/2024 and conducted by Evaluator Wendy Gibbs
COMPLAINT CONTROL NUMBER: 11-AS-20240318132553

FACILITY NAME:SILVERADO ROLLING HILLSFACILITY NUMBER:
198320131
ADMINISTRATOR:LOURDES MENCHACAFACILITY TYPE:
740
ADDRESS:2455 PACIFIC COAST HWYTELEPHONE:
(424) 488-0593
CITY:TORRANCESTATE: CAZIP CODE:
90505
CAPACITY:68CENSUS: 41DATE:
05/02/2025
UNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Taylor GiuntoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Residents' rooms are not being cleaned
Facility does not have a signal system
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/02/2025 the department conducted an unannounced subsequent complaint visit. During today’s visit the department toured the facility and delivered findings for the complaint listed above.
The investigation consisted of the following:
During the initial visit, conducted on 3/27/2024, the department toured the facility, interviewed Staff (S2-S12) interviewed Residents (R1-R6), interviewed Residents Responsible Party (W1-W5), and received documents pertinent to the investigation. The documents received include Staff Roster, Resident Roster, Staff Training Logs, Incontinent Resident List, resident eMAR (electronic Medication Administration Record), Room Cleaning Schedule, Change of Administrator Letter, updated LIC 308 (Designation of Facility Responsibility), Board of Directors Resolution letter, Residential Care for the Elderly Administrator Certificate which expires on 10/20/24, resume, LIC 501 (Personnel Record), current LIC 503 (Health Screening),valid CPR and First Aid training which valid till 09/19/25, Driver’s License, updated LIC500 (Personnel Report), updated LIC610E (Emergency and Disaster Plan), and Criminal Background Clearence.
The investigation revealed the Following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 8 of 10
Control Number 11-AS-20240318132553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SILVERADO ROLLING HILLS
FACILITY NUMBER: 198320131
VISIT DATE: 05/02/2025
NARRATIVE
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Allegation: Residents’ rooms are not being cleaned
The details of the complaint alleged that facility staff are not cleaning residents’ rooms.
During the facility inspection, LPA visited rooms 105,106,109, and 217. LPA observed the rooms were clean and in good repair. LPA observed housekeeping cleaning rooms during the facility inspection.
During record review, LPA received and reviewed Silverado Checklist Daily Housekeeping that lists areas in the facility that are to be cleaned on that day and the list of rooms. Additionally, LPA received and reviewed a copy of a Monthly Calander that lists Deep Cleaning of Resident’s rooms, areas in the facility that are to be deep cleaned, Carpet Shampoos, and Disinfecting high touch areas and surfaces.
During an interview with Staff (S2-S12), were asked how often resident rooms are cleaned, eleven (11) out of eleven (11) stated resident rooms are cleaned daily and a deep cleaning is done weekly.
During interviews with Residents (R1-R6), were asked how often their room is cleaned, six (6) out of six (6) stated, their room is cleaned every day.
During interviews with Witnesses W1-W5, were asked how often their resident’s room is cleaned, five (5) out of five (5) stated their residents’ room is cleaned daily.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.


Allegation: Facility does not have a signal system
The details of the complaint alleged that residents yell for assistance because the facility does not have a signal system.
During the facility tour, LPA heard a resident yelling for help, LPA observed a caregiver come to the resident’s room to assist the resident. While standing in the doorway, LPA heard the caregiver ask the resident in the room if they needed assistance and how they can help, and the resident responded, “no I am okay.” Immediately after the caregiver left the resident began yelling for help again. Additionally, during the facility tour, LPA tested residents watch pendants for the following rooms 105,106,109, 116, 204, 223, and 217. Caregivers responded to the pendants under 8 minutes.
During an interview with Staff (S2-S12), were asked if there has been any issues with the signal system,
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 9 of 10
Control Number 11-AS-20240318132553
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: SILVERADO ROLLING HILLS
FACILITY NUMBER: 198320131
VISIT DATE: 05/02/2025
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eleven (11) out of eleven (11) stated there have been no issues with the pendants. Staff S2-S12 were asked how soon residents calls for assistance are answered, eleven (11) out of eleven (11) stated they respond as soon as possible. Additionally, during interviews with staff, seven (7) out of eleven (11) stated if they are assisting another resident they will radio to see if another caregiver can go check on them.
During interview with Residents (R1-R6), were asked if their calls for assistance are answered in a timely manner, five (5) out of six (6) stated staff come right away to assist them. One (1) out of six (6) stated they do not require that type of assistance.
During interviews with Witnesses W1-W5, were asked if their resident’s call for assistance are answered in a timely manner, five (5) out of five (5) stated yes, staff come right away.

During the investigation, the department did not find sufficient evidence to support the above-mentioned allegations. Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard was not met. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.



An exit interview was conducted with Administrator, Taylor Giunto, and a copy of this report was provided.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
Page: 10 of 10