415600874-11-15-2023-14-AS-KHOS-CY2L2G-20231129072220

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415600874
Report Date: 11/15/2023
Date Signed: 11/15/2023 11:31:19 AM

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
11/13/2023 and conducted by Evaluator Jaime Vado

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20231113131429

FACILITY NAME:	BROOKDALE REDWOOD CITY		FACILITY NUMBER:	415600874
ADMINISTRATOR:	MONICA CERON TAPIA		FACILITY TYPE:	740
ADDRESS:	485 WOODSIDE RD		TELEPHONE:	(650) 366-3900
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY:	130	CENSUS: 68	DATE:	11/15/2023
		UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Monica Tapia		TIME COMPLETED:	11:35 AM

ALLEGATION(S):

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Resident was left unattended without assistance for an extended period

INVESTIGATION FINDINGS:

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On this day Licensing Program Analysts (LPA) Jaime Vado and Grace conducted an unannounced complaint investigation visit. LPAs met with the administrator Monica Tapia and explained the purpose of today's visit.

During today's investigation it was discvered that the resident in question resides in independent living. LPAs reveiwed the file of the resident and observed the residency agreement the resident has with the facility. According to the file and agreement there is no care plan due to the resident being in independent living. The resident does receive home helath services due to a recent surgery where they come every week at least twice. This allegation is unfounded.

This agency has investigated the complaint alleging, "Resident was left unattended without assistance for an extended period". 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.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: April Cowan	TELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Jaime Vado	TELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

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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