275202591-10-10-2023-24-AS-BCHN-CZK2WV-20240116164609

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 275202591
Report Date: 08/28/2023
Date Signed: 10/10/2023 03:03:48 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
05/25/2023 and conducted by Evaluator David Ayers

COMPLAINT CONTROL NUMBER: 24-AS-20230525122858

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: 116	DATE:	08/28/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Tiffaney Santoro - Executive Director		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Unlawful eviction

INVESTIGATION FINDINGS:

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On 8/29/2023, Licensing Program Analyst (LPA) D. Ayers conducted an unannounced complaint inspection. LPA met with Executive Director Tiffaney Santoro. The purpose of this visit is to deliver the finding of the investigation completed by the Department.

During the course of the investigation, the department inspected the facility, conducted interviews, and reviewed records. On 4/25/2023 R1 was sent to the emergency room and had a catheter inserted. R1 was discharged to a skilled nursing facility(SNF) on 4/28/2023 with a catheter still in. The catheter was removed on 5/12/2023 by SNF staff and again inserted on 5/13/2023. On 5/23/2023 Merrill Gardens at Monterey staff notified the responsible party of R1 that they could not accept R1 back due to them still having an indwelling catheter inserted. As of 5/31/2023, R1 was still residing at the SNF, and still had a catheter in. Merrill Gardens at Monterey was not able to accept R1 due to requirements as stated in CCR Title 22 Division 6, Chapter 8, Section 87623(a)(1) Based on the interviews conducted, documentation obtained and reviewed, and the information received during this investigation, the preponderance of evidence standard has not been met; therefore, the above allegation is found to be unsubstantiated at this time. Exit interview conducted and a copy of the report was provided.

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: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

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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