385600429-4-12-2022-14-AS-JMOS-CDVSH4-20220427135254

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 385600429
Report Date: 04/12/2022
Date Signed: 04/12/2022 12:28:32 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/14/2021 and conducted by Evaluator Murial Han

COMPLAINT CONTROL NUMBER: 14-AS-20211214115249

FACILITY NAME:	COVENTRY PLACE		FACILITY NUMBER:	385600429
ADMINISTRATOR:	MARK NITSCHE		FACILITY TYPE:	740
ADDRESS:	1550 SUTTER STREET		TELEPHONE:	(415) 921-1552
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94109
CAPACITY:	210	CENSUS:	DATE:	04/12/2022
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	administrator, Mark Nitsche		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

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Facility is in disrepair.

INVESTIGATION FINDINGS:

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On 4/12/2022, Licensing Program Analyst (LPA) Murial Han conducted an unannounced visit to deliver the findings of complaint # 14-AS-20211214115249. LPA Han met with the Administrator, Mark Nitsche and explained the purpose of the visit.

Regarding the allegation of- facility is in disrepair, the Reporting Party stated that the facility did not have hot water from 12/2/21 to 12/14/21, the facility failed to provide an alternate location for the residents to get a hot shower during the repair and the facility did not provide proper communication to the residents during the repair.

During the investigation, LPA Han interviewed the administrator, the resident service director, and 7 residents.

The administrator stated that the facility learned about the problem on a Sunday and called the plumbing company right away and a plumber came out on the next day. The facility has also conducted an assessment and discovered 7-12 apartments did not have hot water due to a malfunctioned circulator hot water pump.

The administrator also reported that the repair took longer than expected because the device for the repair was only available from another state. Therefore, the shipment delayed the repair time. However, residents were offered to have hot showers in the apartments that were not affected by this problem.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Julio Montes	TELEPHONE: (650) 266-8811
LICENSING EVALUATOR NAME: Murial Han	TELEPHONE: (619) 209-9761
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022

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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Control Number 14-AS-20211214115249

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: COVENTRY PLACE	FACILITY NUMBER: 385600429
	VISIT DATE: 04/12/2022

NARRATIVE

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LPA Han interviewed the residents and 7 out of 7 residents validated that management proceed with actions right away when they discovered that there was no hot water in the building and they did receive updates regarding the repair from the management staff through the "Text- En- All" broadcast system. However, all of them also stated that they were not offered an alternate location for them to take a hot shower during the repair. This deficiency will be cited on LIC809D.

Based on observation, interviews and record reviews during the course of the investigation, the above allegation is unsubstantiated. The facility did not have hot water for a few days due to a malfunctioned circulator hot water pump but the facility director proceed with actions on the same day when the problem was reported and the delay of the repair was due to a part that had to be shipped from another state.

Although the above investigation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

This report is reviewed and discussed with the administrator. A copy is provided.

SUPERVISOR'S NAME: Julio Montes	TELEPHONE: (650) 266-8811
LICENSING EVALUATOR NAME: Murial Han	TELEPHONE: (619) 209-9761
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022

LIC9099 (FAS) - (06/04)

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