275202591-4-1-2022-26-AS-SPIY-CDDN8C-20220411101406

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275202591
Report Date: 03/30/2022
Date Signed: 04/01/2022 09:15:51 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/25/2021 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 26-AS-20211025111710

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: 102	DATE:	03/30/2022
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Administrator Tiffaney Santoro		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Emergency back up power did not operate during power outage

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Shawna Doucette contacted the facility to commence a complaint investigation. LPA conducted a visit and took COVID-19 pre-cautionary measures. LPA identified herself and explained the purpose of the visit was to deliver findings to Administrator TiffaneySantoro.

Based on interviews the power went out at the facility for about 1 1/2 hours to 3 hours during the day the facility provided glow sticks, flashlights, flood lights and checked on residents frequently during the outage. Based on record review, as per facilities disaster plan, if power is out for an extensive amount of time facility is contracted with a company for a back generator which will be provided to the facility.

Although the allegation Emergency back up power did not operate during power outage may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted and a copy of this report was emailed to the Administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 650-7923
LICENSING EVALUATOR NAME: Shawna Doucette	TELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

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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