415600154-9-23-2025-14-AS-ACON-DMVRE4-20251028125652

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415600154
Report Date: 09/23/2025
Date Signed: 09/23/2025 02:25:55 PM

Unfounded

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
07/24/2025 and conducted by Evaluator Jaime Vado

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20250724085454

FACILITY NAME:	MAGNOLIA OF MILLBRAE		FACILITY NUMBER:	415600154
ADMINISTRATOR:	LOLA BORREGO		FACILITY TYPE:	740
ADDRESS:	201 CHADBOURNE AVENUE		TELEPHONE:	(650) 697-7700
CITY:	MILLBRAE	STATE: CA	ZIP CODE:	94030
CAPACITY:	180	CENSUS: 137	DATE:	09/23/2025
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Administrator - Lola Borego and Assistant Executive Director - R.N. Charito Amoranto		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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- Staff are confining resident to room

INVESTIGATION FINDINGS:

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On 09/23/2025, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings regarding the allegation received. LPA met with both Administrator - Lola Borego and Assistant Executive Director - R.N. Charito Amoranto and explained the purpose of today's visit.

During the investigation, LPA interviewed staff, residents, and made observations were made of the residents room. Per interviews conducted the resident denies being locked in their room. Room can be unlocked by turning the door handle from the inside of the room. The door can be locked from both inside and outside but can always be opened from the inside by turning the handle. Based on interviews with staff the room is locked when staff exit the room per resident's request. This allegation is unfounded.

This agency has investigated the complaint alleging, Staff are confining resident to room. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Report is reviewed with Administrator - Lola Borego and Assistant Executive Director - R.N. Charito Amoranto. Facility is provided a copy during today's visit.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Jaime Vado
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025

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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