415600964-12-5-2023-14-AS-KHOS-CYENCX-20231211092128

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415600964
Report Date: 12/05/2023
Date Signed: 12/05/2023 11:02:07 AM

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
06/13/2023 and conducted by Evaluator Jaime Vado

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20230613102340

FACILITY NAME:	KENSINGTON PLACE REDWOOD CITY		FACILITY NUMBER:	415600964
ADMINISTRATOR:	JOAN NEWMAN		FACILITY TYPE:	740
ADDRESS:	2800 EL CAMINO REAL		TELEPHONE:	(650) 363-9200
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY:	67	CENSUS: 41	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Douglas Blake		TIME COMPLETED:	11:10 AM

ALLEGATION(S):

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- Staff did not ensure resident received their mail in a timely manner

INVESTIGATION FINDINGS:

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On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit to deliver the findings regarding the allegation received. LPA met with Douglas Blake, soon to be administrator, and explained the purpose of today's visit.

During the investigation LPA conducted interviews and made facility observations. It was discovered that the facility explains to responsible parties during the admission process that dementia resident mail is to be picked up from a centralized mail filing cabinet that holds resident mail. Bills and other important medical items are primarily housed in the mail filing cabinet. Due to no further information being received from incoming complainant this allegation is unsubstantiated.

Based on these observations, the above allegations are UNSUBSTANTIATED.
Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are unsubstantiated at this time.

Unsubstantiated

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: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

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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