385601116-5-10-2023-14-AS-KHOS-CSBLUC-20230530090343

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 385601116
Report Date: 05/10/2023
Date Signed: 05/10/2023 12:15:54 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SF COASTAL AC/SC, 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
03/28/2023 and conducted by Evaluator Murial Han

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20230328165214

FACILITY NAME:	COTERIE CATHEDRAL HILL		FACILITY NUMBER:	385601116
ADMINISTRATOR:	LALOYAN,SIRUN SARAH		FACILITY TYPE:	740
ADDRESS:	1001 VAN NESS AVENUE		TELEPHONE:	(415) 915-6615
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94109
CAPACITY:	260	CENSUS: 101	DATE:	05/10/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator, Sarah Laloyan		TIME COMPLETED:	12:25 PM

ALLEGATION(S):

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Facility doors are not in good repair
Resident was not accorded safe, healthful and comfortable accommodations as related to malfunctioned door(s)

INVESTIGATION FINDINGS:

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On 5/10/2023 , Licensing Program Analyst (LPA) Murial Han conducted an unannounced visit to deliver the findings of complaint # 14-AS-20230328165214. LPA Han met with administrator and explained the purpose of the visit.

Regarding to the allegation of facility doors are not in good repair- the reporting party stated that resident #1 (R1) fell and was injured because the 3rd floor lobby door closed by itself and the same resident was locked outside on the rooftop because the door was not working. In addition, the reporting party stated that often it does not work as the doors start to close on the person who was trying to get in or get out.

As part of the investigation LPA conducted facility tour and tested the rooftop and 3rd floor doors, LPA interviewed R1 and building engineer.

During the facility tour, LPA observed both the 3rd floor and the rooftop doors were functioning properly. LPA also observed if the door starts to close while someone is still trying to get in or out, the door will automatically open when the censor detaches that person.

LPA interviewed R1 who stated that he/she was not locked out of the building on the roof top. In addition, R1 stated that R1 enjoyed the dog park on the roof.

LPA interviewed 4 additional residents and all of them reported that they did not have any concerns regarding the 3rd floor and the rooftop doors and those doors never closed on them when they were going in and out.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cara Smith	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Murial Han	TELEPHONE: (619) 209-9761
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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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Control Number 14-AS-20230328165214

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SF COASTAL AC/SC, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: COTERIE CATHEDRAL HILL	FACILITY NUMBER: 385601116
	VISIT DATE: 05/10/2023

NARRATIVE

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According to the building engineer, no one has reported the doors were broken and/or a resident was stranded on the rooftop for 45 minutes. In addition, the building engineer explained that if any of the doors were malfunctioned and residents were locked outside, they could talk into their tempo (wrist watch) and request assistance from facility staff.

In addition, the building engineer stated that rooftop door was serviced in November, 2022.

After the investigation, this allegation is deemed to be unsubstantiated.

Regarding to allegation of- resident was not accorded safe, healthful and comfortable accommodations as related to malfunctioned door(s), the reporting party stated that R1 fell multiple times due to the doors.

As part of the investigation, LPA interviewed R1 and other residents.

According to R1, he/she fell one time on the rooftop while walking the dog. However, he/she slipped but it was not related to the doors.

Based on documentation provided, it revealed that R1 slipped and fell once on the rooftop while walking the dogs.

LPA interviewed 4 additional residents and all of them reported that they have not encountered the 3rd floor and the rooftop doors being malfunctioned.

After the investigation, this allegation is deemed to be unsubstantiated.

Although the above investigations 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: Cara Smith	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Murial Han	TELEPHONE: (619) 209-9761
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

LIC9099 (FAS) - (06/04)

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