410508863-2-21-2025-14-AS-ACON-DEF3M9-20250303172159

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 410508863
Report Date: 02/21/2025
Date Signed: 02/21/2025 01:05:56 PM

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
02/19/2025 and conducted by Evaluator Komal Charitra

COMPLAINT CONTROL NUMBER: 14-AS-20250219151738

FACILITY NAME:	BRUCE-BADILLA'S CARE HOME		FACILITY NUMBER:	410508863
ADMINISTRATOR:	BRUCE-BADILLA, LIGAYA		FACILITY TYPE:	735
ADDRESS:	344 FRANKFORT		TELEPHONE:	(415) 587-0539
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94014
CAPACITY:	12	CENSUS: 12	DATE:	02/21/2025
		UNANNOUNCED	TIME BEGAN:	11:11 AM
MET WITH:	Administrator, Bruce-Badilla Ligaya		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Residents are not getting an adaquate amount of food to meet their needs
Facility staff are not addressing a coackcoach problem
Facility staff are not allowing resident to receive visitors
Facility staff are not safeguarding resident's belongings

INVESTIGATION FINDINGS:

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On February 21, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced 10-day complaint visit. LPA met with Administrator, Bruce-Badilla Ligaya and explained the purpose of the visit.

Regarding the allegation, residents are not getting an adequate amount of food to meet their needs, according to the reporting party, the facility is not feeding his/her son.

During the investigation, LPA interviewed 5 residents who indicated the food is good and they are provided 3 meals and day and are offered snacks throughout the day. LPA reviewed the facility’s food menu and observed the staff member cooking stir fry noodles with meat and veggies, which was listed on the food menu for the day.

Regarding the allegation, facility staff are not addressing a cockroach problem, according to the reporting party, the facility has a cockroach infestation throughout the premises. (Continue to 9099C).

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Komal Charitra
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025

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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Control Number 14-AS-20250219151738

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: BRUCE-BADILLA'S CARE HOME	FACILITY NUMBER: 410508863
	VISIT DATE: 02/21/2025

NARRATIVE

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During the investigation, LPA interviewed 6 residents, 4/6 residents indicated that they’ve seen cockroaches at the facility, however staff does treatment. Administrator provided LPA receipts of the treatment solution that was purchased, in addition LPA observed all the treatment solution in the garage. According to the administrator and staff interviewed, the facility was sprayed inside and outside with the treatment solution and are spraying as needed.

Regarding the allegation, facility staff are not allowing resident to receive visitors, according to the reporting party, the facility does not allow Resident 1 (R1) to receive family visitation.

During the investigation, LPA interviewed the administrator who indicated that they did not refuse visitation, however notified R1’s family member to contact R1’s conservator who is the responsible party. R1’s family member was still able to come visit according to staff interviewed. LPA interviewed 5 residents, 3/5 indicated that they have family that come to the facility to visit.

Regarding the allegation, facility staff are not safeguarding resident’s belongings, according to the reporting party, the facility lost Resident 1 (R1’s) French dutch oven.

During the visit, LPA interviewed R1, administrator and reviewed R1’s LIC621 (Client/Resident Personal Property and Valuables). Based on R1’s LIC621, there was no personal belongings logged. According to the administrator, R1 did bring in personal belongings, however it was not logged because R1 keeps it in his/her room and is responsible for it. In addition, administrator indicated that items are logged on the LIC621 only if the facility holds on to the belongings for residents. LPA interviewed R1 who indicated he/she does not remember bringing a dutch oven to the facility and will check his/her previous facility.

Based on the interviews conducted, information collected, and observations made, the department has determined that although the above allegations 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.

Report is reviewed with Administrator and a copy is provided.

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Komal Charitra
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025

LIC9099 (FAS) - (06/04)

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