198602870-3-19-2024-28-AS-FFIS-D4CPQ9-20240415113043

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602870
Report Date: 03/19/2024
Date Signed: 03/19/2024 11:37:20 AM

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
03/13/2024 and conducted by Evaluator Valeria Maldonado

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240313102337

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: 58	DATE:	03/19/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Tucker Brugh- Executive Director		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Facility does not have a qualified administrator.

INVESTIGATION FINDINGS:

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

During today's visit, LPA's Maldonado and Reyes obtained a copy of the resident and staff rosters and the following documents for ED Brugh and HSD O'Neel: Personnel Record and Administrator Certificate. LPA's also conducted interviews with ED and HSD.

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: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

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-20240313102337

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: 03/19/2024

NARRATIVE

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Regarding allegation: Facility does not have a qualified administrator.
It is alleged that Tucker Brugh has been acting as the administrator of the facility since November 2023 and is not certified to be one. Per interview with ED Brugh, he has been working at the facility as the Executive Director since 11/27/23. He states to have worked at many Residential Care Facilities for the Elderly (RCFE) as an Administrator in Arizona, Nevada, Montana, and California and has his Administrator Certificate for RCFE in California. He also has his Nursing Home Administrator Certificate through the Department of Public Health. Per interview with HSD O'Neel, Tucker is qualified to be the administrator at this facility and has been in the position since November 2023. HSD O'Neel states she also has her Administrator certificate for RCFE and is ED Brugh's designated back-up Administrator, to handle matters if he is unavailable. Per ED Brugh's Personnel Record obtained, it was discovered that he has several college degrees with over (2) years of college completed, which meets the educational requirement of (2) years of college. ED Brugh also has experience in providing residential care to the elderly since 2010, which is more than the required (3) years of experience. He currently has a pending Administrator Certificate# 6071136740 with the licensing agency's Administration Certification Bureau. Per HSD O'Neel's Personnel Record obtained, it was discovered that she has (2) years completed of college, which meets the educational requirement of (2) years and has experience in providing residential care to the elderly since 2021, which meets the requirement of (3) years experience. She currently has an active Administrator Certificate# 6064890740, with expiration date: 12/08/2024.

Based on the interviews conducted and records reviewed: 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 with ED Tucker Burgh and HSD Heather O'Neel, 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: 03/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2024

LIC9099 (FAS) - (06/04)

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