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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275202407
Report Date: 08/21/2024
Date Signed: 08/21/2024 03:22:01 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
05/08/2024 and conducted by Evaluator Brianna Miranda
COMPLAINT CONTROL NUMBER: 24-AS-20240508133911
FACILITY NAME:MONTEREY BAY GUEST HOMEFACILITY NUMBER:
275202407
ADMINISTRATOR:EMMANUEL & JENNIFER INNEHFACILITY TYPE:
735
ADDRESS:1100 CARSON STREETTELEPHONE:
(831) 920-1796
CITY:SEASIDESTATE: CAZIP CODE:
93955
CAPACITY:22CENSUS: 14DATE:
08/21/2024
UNANNOUNCEDTIME BEGAN:
01:53 PM
MET WITH:Staff Larry RimasTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Facility is in disrepair
Facility staff forced resident to take PRN medications
Facility staff are not meeting the needs of residents in care
INVESTIGATION FINDINGS:
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On 8/21/2024 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver the findings for the allegation(s) listed above. LPA introduced herself, explained the reason for the visit, and was allowed entrance into the facility by Staff Larry Rimas. Administrator (AD) Emmanuel Inneh was contacted.

1. The Department investigated the allegation: Facility is in disrepair. LPA observed the two water heaters at the facility to be in working condition. Staff Larry Rimas stated the water heaters were previously purchased within the past year. LPA observed water heaters to look new. LPA asked if there were prior leaks inside the facility, Staff Larry Rimas stated there was a leak in the patio area but not inside. LPA did not observe any leaks. During interviews there was no indication of the roof leaking or issues with the water heaters.




Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2024
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 24-AS-20240508133911
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: MONTEREY BAY GUEST HOME
FACILITY NUMBER: 275202407
VISIT DATE: 08/21/2024
NARRATIVE
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2. The Department investigated the allegation: Facility staff forced resident to take PRN medications. LPA was not able to interview R1. LPA interviewed R2, R3, R4, and S1 interviewees did not state they were forced to take PRN medications or any another medications.

3. The Department investigated the allegation: Facility staff are not meeting the needs of residents in care. LPA was not able to interview R1. LPA interviewed R2, R3, R4, and S1 interviewees did not state their needs were not being met.

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 are unsubstantiated.

Exit interview was conducted and a copy of this report LIC9099 provided to Staff Larry Rimas.

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2