<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275202591
Report Date: 12/14/2024
Date Signed: 12/23/2024 11:16:43 AM

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
05/31/2024 and conducted by Evaluator Sarah Hurt
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20240531111520
FACILITY NAME:MERRILL GARDENS AT MONTEREYFACILITY NUMBER:
275202591
ADMINISTRATOR:TIFFANEY SANTOROFACILITY TYPE:
740
ADDRESS:200 IRIS CANYON RDTELEPHONE:
(831) 250-0930
CITY:MONTEREYSTATE: CAZIP CODE:
93940
CAPACITY:150CENSUS: 115DATE:
12/14/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Senior Executive Chef, Jaime Rios TIME COMPLETED:
05:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unqualified staff left in charge of residents
Staff did not properly assess resident
Staff are not checking on resident
Staff are not providing adequate food service to residents
Staff are not ensuring residents have activities
Staff are not ensuring resident's room is kept clean
Staff are not reminding resident about appointments
Staff are not ensuring resident was given a shower
Staff are not ensuring resident's dog was taken care of
Staff are not meeting residents needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to deliver findings on the allegations listed above . LPA met with facility Senior Executive chef Jaime Rios, and explained the purpose of today's visit.


Regarding the allegation Unqualified staff left in charge of residents. Staff 1 is quailfied to be in charge when Administrator is not present at the facility. 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 ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2024
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 3
Control Number 24-AS-20240531111520
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: 12/14/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Regarding the allegation Staff did not properly assess resident. Resident 1 was assessed on 01/23/2024, and again on 05/15/2024. Resident 1 signed both assessments acknowledging they reviewed and agree to pay level of care fees. Resident 2 was assessed upon admission to this facility, on 03/14/24, and 05/02/24. Resident 2's assessments were all signed by the Responsible party. 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.

Regarding the allegation Staff are not checking on resident. Resident 2 stated facility staff checks on them several times daily. LPA Hurt interviewed 4 facility residents who all stated the staff is kind and checks on them often. 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.

Regarding the allegation Staff are not providing adequate food service to residents. Resident 1 stated the facility does provide an adequate amount of food. LPA Hurt interviewed 4 facility residents who all stated the facility food is good and there are lots of other options if they don't like the daily main course. LPA reviewed menus in residents bedrooms and posted throughout the facility. 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.

Regarding the allegation Staff are not ensuring residents have activities. Resident 2 stated the facility does provide activities but they chose not to participate in most of them. Executive Director documents resident 2 was offered to attend activities on several occasions and declined. LPA Hurt interviewed 4 facility residents who all stated the facility provides plenty of activities including exercise, movies, swim, card games, and music. LPA Hurt observed several activity calendars posted throughout the facility. 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.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20240531111520
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: 12/14/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Regarding the allegation Staff are not ensuring resident's room is kept clean. Resident 2 stated their room is cleaned twice weekly. LPA observed Resident 2's room appeared to be clean and tidy. LPA Hurt interviewed four facility residents who all stated their room is cleaned once or twice weekly and they are happy with the housekeeping services 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.

Regarding the allegation Staff are not reminding resident about appointments. Resident 2 stated they do not have many appointments and they are taken to appointments by their daughter. LPA interviewed 4 facility residents who all stated they make their own appointments and are taken to appointments either by family, private caregiver or facility staff. 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.

Regarding the allegation Staff are not ensuring resident was given a shower. Resident 2 stated they are showered when a shower is requested. LPA reviewed several "Shower refusal" forms signed by Resident 2 documenting they did often decline showers. 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.

Regarding the allegation Staff are not ensuring resident's dog was taken care of. Facility staff is not responsible for ensuring resident pets are cared for. Resident 1 stated his pet was difficult to care for and was eventually taken to the local SPCA, and adopted into a good home. 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.

Regarding the allegation Staff are not meeting residents needs. Resident 2 stated the facility staff cleans their room, the facility has activities, the facility food is ok, the facility staff assists with showers as needed, and the staff is very friendly. LPA Hurt interviewed 4 facility residents who all stated the facility has activities, food, and friendly staff. 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.

Exit interview conducted with Jaime Rios, and a copy of this report along with appeals rights provided.
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3