275202591-3-8-2024-24-AS-BCHN-D72NK7-20240710103127

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275202591
Report Date: 03/07/2024
Date Signed: 03/08/2024 04:18:17 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
02/28/2024 and conducted by Evaluator David Ayers

COMPLAINT CONTROL NUMBER: 24-AS-20240228154207

FACILITY NAME:	MERRILL GARDENS AT MONTEREY		FACILITY NUMBER:	275202591
ADMINISTRATOR:	TIFFANEY SANTORO		FACILITY TYPE:	740
ADDRESS:	200 IRIS CANYON RD		TELEPHONE:	(831) 250-0930
CITY:	MONTEREY	STATE: CA	ZIP CODE:	93940
CAPACITY:	150	CENSUS: 122	DATE:	03/07/2024
		UNANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Amor Sorius - Senior Business Office Director		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Resident was trapped in the elevator due to facility not obtaining back-up power.

INVESTIGATION FINDINGS:

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On 3/7/2024, Licensing Program Analyst(LPA) D. Ayers arrived at the facility unannounced to conduct an initial 10-day complaint inspection. LPA met with Senior Business Office Director Amor Sorius and announced the purpose of the inspection. During the visit, LPA conducted interviews, obtained records, and conducted a tour of the facility.

Allegation - Resident was trapped in the elevator due to facility not obtaining back-up power.

Based on records review, observations, and interviews, facility staff have prepared a comprehensive emergency disaster plan. On 2/4/2024, a resident could not exit the elevator for approximately two hours due to a power outage. The elevator was opened by emergency responders. Facility elevator has been properly serviced and maintained. No resident was injured during the power outage. 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. An exit interview was conducted, and a copy of the report was provided via email.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: David Ayers	TELEPHONE: 559-498-4163
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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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