275202407-12-5-2023-24-AS-BCHN-D49VNN-20240412163525

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275202407
Report Date: 12/05/2023
Date Signed: 12/05/2023 01:19:48 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/27/2023 and conducted by Evaluator Brianna Miranda

COMPLAINT CONTROL NUMBER: 24-AS-20231127091509

FACILITY NAME:	MONTEREY BAY GUEST HOME		FACILITY NUMBER:	275202407
ADMINISTRATOR:	EMMANUEL & JENNIFER INNEH		FACILITY TYPE:	735
ADDRESS:	1100 CARSON STREET		TELEPHONE:	(831) 920-1796
CITY:	SEASIDE	STATE: CA	ZIP CODE:	93955
CAPACITY:	22	CENSUS: 17	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	10:56 AM
MET WITH:	Caregiver Larry Rimas		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff are not properly addressing bed bugs infestation

INVESTIGATION FINDINGS:

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On 12/5/2023 at 11:00 a.m. Licensing Program Analyst (LPA) B. Miranda & V. Gorbin arrived at the facility unannounced to investigate the allegation listed above. LPAs met with Caregiver Larry and announced the purpose of the visit.
LPAs toured the facility and found dead bed bugs located in one of the male rooms.
Staff at the facility stated there is no bed bug issue and it was a resident with lice. Staff stated the facility is sprayed but could not tell LPAs how often.
LPAs interviewed residents who stated there were bed bugs but the facility sprayed and there currently is none. Facility will provide current invoice for pest control by end of business day 12/7/23.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.
Exit interview conducted, a copy of this report LIC9099 was provided to Larry Rimas.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

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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