198600316-8-15-2023-28-AS-LHIS-CUXK8Y-20230822074132

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600316
Report Date: 08/15/2023
Date Signed: 08/15/2023 01:49:53 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/11/2023 and conducted by Evaluator Angelica Rea

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230811163123

FACILITY NAME:	SERRANO HOME CARE SERVICES, INC.		FACILITY NUMBER:	198600316
ADMINISTRATOR:	GO, VILMA		FACILITY TYPE:	735
ADDRESS:	356 SOUTH SERRANO AVENUE		TELEPHONE:	(213) 385-0237
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90020
CAPACITY:	15	CENSUS: 14	DATE:	08/15/2023
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Bien Payuyo, Assistant Administrator		TIME COMPLETED:	02:05 PM

ALLEGATION(S):

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9

Staff yelled at resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Rea conducted an initial complaint visit in response to the allegation listed above. LPA met with Assistant Administrator, Bien Payuyo, who assisted with today's visit.

Regarding the allegation that : staff yelled at resident #1. The investigation consisted of interviews with Staff #1, Staff #2, Resident #1 - Resident #4, and review of Resident #1's file. Staff interviewed denied the allegation, they stated that staff do not yell at residents. Residents interviewed were unable to corroborate the allegation. 3 out of 4 residents interviewed stated that staff do not yell at residents.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with Ms. Payuyo and a copy of this report was provided.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Angelica Rea
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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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