275202591-9-13-2024-24-AS-BCHN-D9DVD4-20240923162005

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275202591
Report Date: 07/27/2024
Date Signed: 09/13/2024 04:27:59 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 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
04/29/2024 and conducted by Evaluator Sarah Hurt

COMPLAINT CONTROL NUMBER: 24-AS-20240429082716

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: 112	DATE:	07/27/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Executive Chef, Jaime Rios		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff does not ensure elevator is in good repair
Staff does not ensure special food service is served with accuracy for residents in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sarah Hurt arrived at the facility unannounced on July 27,2024 at 1:00 p.m. to investigate the above allegation. LPA met with Executive Chef Jaime Rios ,and explained the purpose for today’s visit.

Regarding the allegation Staff does not ensure elevator is in good repair. Facility Administrator stated there was an issue where one of the facility elevators was not working for a period of time, but there is always another elevator available for residents. During the time when the elevator was not working facility staff offered free food delivery to residents rooms, and assistance with getting to the second elevator for any residents that need assistance. Facility Administrator stated the elevator is currently repaired and working. 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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah Hurt	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2024

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 24-AS-20240429082716

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: MERRILL GARDENS AT MONTEREY	FACILITY NUMBER: 275202591
	VISIT DATE: 07/27/2024

NARRATIVE

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Continued...

Regarding the allegation Staff does not ensure special food service is served with accuracy for residents in care. Reporting Party stated the food service delivery provided when the facility elevator was not working went really well with no issues. Reporting party stated the food service was prompt, and everything ordered was provided. 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.

No deficiencies cited today Per Title 22 Regulations.

Exit interview conducted with facility Jaime Rios, and copy of report provided.

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah Hurt	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2024

LIC9099 (FAS) - (06/04)

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