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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602870
Report Date: 04/11/2024
Date Signed: 04/11/2024 01:31:41 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
02/29/2024 and conducted by Evaluator Nune Margaryan
COMPLAINT CONTROL NUMBER: 28-AS-20240229101457
FACILITY NAME:SERENTO CASAFACILITY NUMBER:
198602870
ADMINISTRATOR:SARAH SESAYFACILITY TYPE:
741
ADDRESS:1740 SAN DIMAS AVENUETELEPHONE:
(909) 394-0304
CITY:SAN DIMASSTATE: CAZIP CODE:
91773
CAPACITY:0CENSUS: DATE:
04/11/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Heather O'Neel TIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Facility has pests.
Facility is in disrepair.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nune Margaryan conducted a subsequent unannounced complaint visit to deliver findings to the above mentioned allegations. LPA met with Heather O'Neel -HSD (Health Service Director) and explained the reason for the visit. Note: This facility has changed ownership effective 04/01/2024.

The investigation consisted of the following: On 03/07/24 LPA N. Margaryan obtained a copy of the resident and staff roster, obtained copies of invoices from Air Temperature INC., Ecolab Pest Elimination Division for 2 months, and conducted a tour of the physical plant in the Assisted Living and Memory Care units with HSD Heather O'Neel. Randomly chosen rooms were inspected. LPA also conducted interviews with Staff #1-7 (S#1-S#7) and Residents #1- #6 (R#1 - R#6).
Continue 9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wei Siew HoTELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune MargaryanTELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
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 28-AS-20240229101457
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: 04/11/2024
NARRATIVE
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Regarding allegation: Facility has pests. It was alleged that roaches and spiders were found in residents' rooms and there was a rat on the 1st floor.

Staff interviewed denied the allegation. Staff stated that the facility has a contract with a pest control company, and the facility is serviced every month. Residents interviewed were unable to corroborate the allegation. Interviewed residents stated that they have not seen any spiders or roaches in their rooms and not seen rats at the facility. LPA did not observe pests / spiders, roaches, and rodents / rats during facility tour. LPA inspected randomly chosen rooms and did not observe any evidence of spiders or roaches in the rooms. LPA toured the common areas including the kitchen and found no evidence of spiders, roaches, or rats inside the facility. LPA also reviewed facility pest control invoices (service dates: 01/11/24, 02/28/24) during the visit and observed that a pest control ECOLAB company comes once a month and sprays pesticide outside of facility to control pests / insects. Also, facility authorized to use a ECOLAB -Finito Natural Multipest Elimination spray, which is safe to use at the facility, including residents rooms. The same company checks on rodents also. Invoices shows there is no rodent activity was noted during the inspections and / or services. No cockroach activity was noted during the inspections and / or services.

Regarding allegation: Facility is in disrepair. It was alleged that there are leaks on the first floor in the hallway going to skilled nursing and in the rooms right in that hallway. There are leaks on the first floor bedrooms and in the kitchen. There several employee rooms and they are all dangerous.

Staff interviewed denied the allegation that facility is in disrepair. They stated that there are no leaks at the facility. Interviewed residents stated that facility is not in disrepair and did not know there was a leak in the hallway. Residents indicated that there is no leak in their rooms. Interviewed staff and residents stated that the facility is in a good condition. LPA toured the facility including the common areas / hallways, randomly chosen residents rooms, employee’s room, kitchen and did not observe any leak.

Although the allegations 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 Heater O'Neel . A copy of this report was provided.

SUPERVISOR'S NAME: Wei Siew HoTELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune MargaryanTELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2