198602870-2-27-2024-28-AS-FFIS-D3J2N4-20240319173205

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602870
Report Date: 02/27/2024
Date Signed: 02/27/2024 01:56:44 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
02/23/2024 and conducted by Evaluator Valeria Maldonado

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240223111637

FACILITY NAME:	SERENTO CASA		FACILITY NUMBER:	198602870
ADMINISTRATOR:	SARAH SESAY		FACILITY TYPE:	741
ADDRESS:	1740 SAN DIMAS AVENUE		TELEPHONE:	(909) 394-0304
CITY:	SAN DIMAS	STATE: CA	ZIP CODE:	91773
CAPACITY:	131	CENSUS: 61	DATE:	02/27/2024
		UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Tucker Brugh- Executive Director & Heather O'Neel- Health Services Director		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff not keeping resident’s personal information confidential.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) V. Maldonado made an unannounced complaint visit to the facility for the purpose of investigating the above-mentioned allegation. LPA Maldonado met with Executive Director (ED), Tucker Brugh, and Health Services Director (HSD), Heather O'Neel, and explained the reason for the visit.

During today's visit, LPA Maldonado obtained a copy of the resident and staff roster, conducted a tour of the physical plant with HSD Heather, and conducted interviews with ED, HSD, Staff# 1-3 (S1-S3), and Residents# 1-5 (R1-R5).

The investigation revealed the following:

(Report Continued on LIC9099-C...)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria Maldonado	TELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

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 28-AS-20240223111637

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: SERENTO CASA	FACILITY NUMBER: 198602870
	VISIT DATE: 02/27/2024

NARRATIVE

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Regarding allegation: Staff not keeping resident’s personal information confidential.
It is alleged that a facility staff is providing confidential information regarding residents, their families, and other staff, to someone outside the facility, telephonically. Per staff interviews, (5) of (5) staff denied the allegation. Staff stated that no related concerns have been brought to their attention, or Human Resources' attention. If this was a concern, an investigation would have been launched regarding the allegation. HSD and S1 stated that during the hiring process and through staff continued training, staff are informed/notified that resident confidential information could not be shared with anyone who is not authorized to be given the information. Per resident interviews, (5) of (5) residents could not corroborate the allegation. Residents stated to not have concerns of their personal information being provided to unauthorized individuals by facility staff.

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.

Per California Code of Regulations, Title 22, no deficiencies were observed or cited during today's visit.

An exit interview was conducted and a copy of this report was provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria Maldonado	TELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024

LIC9099 (FAS) - (06/04)

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