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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 385600377
Report Date: 06/05/2025
Date Signed: 06/05/2025 10:16:06 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/24/2025 and conducted by Evaluator Yi Sam Jian
COMPLAINT CONTROL NUMBER: 14-AS-20250124103912
FACILITY NAME:MERCED GIRARD RESIDENTIAL CARE FACILITYFACILITY NUMBER:
385600377
ADMINISTRATOR:WU, JAMES O.DFACILITY TYPE:
740
ADDRESS:129 GIRARD STREETTELEPHONE:
(415) 467-8900
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:42CENSUS: 41DATE:
06/05/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Administrator, Joyce LeeTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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-Facility staff's neglect/lack of care and supervision led to resident death.
-Facility staff failed to seek timely medical attention for resident admitted to the hospital with septic condition.
INVESTIGATION FINDINGS:
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On 06/05/2025 Licensing Program Analyst (LPA) Yi Sam Jian conducted an unannounced complaint inspection to deliver findings regarding the complaint allegations received. LPA met with administrator, Joyce Lee, LPA explained the purpose of the visit.
Regarding the allegation that facility staff’s neglect/lack of care and supervision led to resident death. Although resident appeared stable with no alarming symptoms reported by staff, hospital physician noted that while earlier intervention might have helped, sepsis can develop rapidly in the elderly without obvious signs, and the family's decision to pursue comfort care was appropriate. Regarding allegation that facility staff failed to seek timely medical attention for resident admitted to the hospital with septic condition. Resident’s medical records show her chief complaint was shortness of breath and she was diagnosed with sepsis, hypovolemic shock, and recurrent stroke, with staff and the administrator reporting no significant changes before hospitalization, and the attending physician noting that in elderly patients, infections like UTIs and sepsis can progress rapidly with few or no symptoms. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove whether the allegations did or did not occur, therefore the above allegations are UNSUBSTANTIATED. Report reviewed and a copy of this report is provided to the administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Yi Sam Jian
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
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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