415600257-9-3-2020-14-AS-JMOS-BTWUGP-20200929153441

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415600257
Report Date: 09/03/2020
Date Signed: 09/03/2020 04:48:25 PM

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
04/23/2020 and conducted by Evaluator Jaime Vado

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20200423130342

FACILITY NAME:	SUNVALLEY CHATEAU PACIFICA		FACILITY NUMBER:	415600257
ADMINISTRATOR:	CHRISTIAN TOPIRCEANU		FACILITY TYPE:	740
ADDRESS:	689 LADERA WAY		TELEPHONE:	(650) 355-8948
CITY:	PACIFICA	STATE: CA	ZIP CODE:	94044
CAPACITY:	16	CENSUS: 9	DATE:	09/03/2020
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Christian Topirceanu		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff was not aware of a residents transportation arrangements

INVESTIGATION FINDINGS:

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On September 3, 2020 at 1530 LPA Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced tele-inspection to deliver the findings regarding the allegation recieved. LPA spoke to administrator CHRISTIAN TOPIRCEANU regarding the allegation.

During the course of the investigation, LPA interviewed the complainant, faciilty licensee, and administrator regarding the allegation as well as received resident admission agreement for review. It is found that the residents in care mode of transporation are handled by the responsible party of each resident. Facility is notified of upcoming appointment pick ups by the responsible party and the facility prepares the resident. Facility does not schedule transporation services unless of an emergency situations.

Based on information gathered, the above allegations were deemed UNFOUNDED.
A finding that is unfounded means the allegation is false, could not have happened, or is without a reasonable basis. Report discussed with administrator and process in which the facility will receive a copy of this report and e-signing via email.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Jaime Vado	TELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2020

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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