385601116-5-10-2023-14-AS-KHOS-CSBLKM-20230530084945

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 385601116
Report Date: 05/10/2023
Date Signed: 05/10/2023 12:14:02 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-20230328125254

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 is without hot water.

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-20230328125254. LPA Han met with administrator and explained the purpose of the visit.

Regarding to allegation of- facility is without hot water, there is no additional information forthcoming from the complainant, however, the co-complainant stated that a maintenance staff was installing a grab bar in the bathroom in one of the apartments and accidentally punctured a hole in the pipe which resulted the facility of not having hot water for 4 days and residents were not able to take a shower.

In addition, the co-complainant stated that the repair would have been fixed a lot sooner had the facility hired an outside plumbing company.

As part of the investigation, LPA toured the facility, tested water temperature in multiple rooms on different floors, interviewed Building Engineer and residents.

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-20230328125254

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, he/she was notified by the facility via phone on 3/25/2023 that one of the technicians was drilling to install a grab bar in a shower room and accidentally punctured a hold in the main hot water line. The building engineer provided instructions to facility over the phone and contacted the facility's general contractor, CW Dillion right away.

The building engineer stated that the contractors arrived at the facility within 30 minutes after the phone call and hot water was restored on the same day and the temperature was measured at 105- 110 degrees F. However, some problems were discovered during the repair which lasted few days but it did not affect the hot water temperature that was also maintained at 105-118 degrees F.

In addition, the building engineer stated that prior to the incident, the hot water temperature was automatically set at 116 degrees F but during the repair, it took a little longer for the hot water to reach 116 degrees F but the temperature was always adequate.

Furthermore, the building engineer stated that as part of the preventive maintenance program, he/she was performing weekly water temperature checks for the entire building and the hot water temperatures were always within range.

Based on the documentation from the outside contractor, they received a call on 3/25/2023 at around 3PM, and hot water was turned on at 5:30PM. They tested the hot water and the temperature was consistent between 105- 110 degrees F. They also noted that the facility was advised that it could take several hours to get above 110 degrees mark as tenants used the hot water.

Based on the facility's weekly temperature log during the week of the repair, it revealed the hot water temperature was measured at 112- 120 degrees F.

LPA interviewed 5 residents and all of them reported that they were aware of the incident, and the hot water was not as hot as usual but it was not cold as well. In addition, they stated that their daily routine was not interrupted by the incident.

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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Control Number 14-AS-20230328125254

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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LPA tested water temperature in 6 apartments on different floors and all the temperature measured at 113- 115.9 degrees F.

Based on interviews, record review and observation. 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

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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