415601039-3-3-2021-14-AS-KHOS-BYYJR6-20210310061614

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415601039
Report Date: 03/03/2021
Date Signed: 03/03/2021 11:06:41 AM

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
06/23/2020 and conducted by Evaluator Bertha Raygoza

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20200623113735

FACILITY NAME:	CADENCE MILLBRAE		FACILITY NUMBER:	415601039
ADMINISTRATOR:	STROMGREN, KIEL		FACILITY TYPE:	740
ADDRESS:	1201 BROADWAY		TELEPHONE:	(650) 742-9150
CITY:	MILLBRAE	STATE: CA	ZIP CODE:	94030
CAPACITY:	188	CENSUS: 101	DATE:	03/03/2021
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Kiel Stromgren, Administrator		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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-Facility is without adequate lighting.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Raygoza made a subsequent complaint Televisit via Facetime on the above allegation. LPA met with Administrator, Kiel Stromgren and stated purpose of visit.

LPA Raygoza and Administrator, Kiel toured via virtual the stairwell and stairway area to assess the emergency lighting. Recent Fire inspection of 2019 notes no issues with anything related to lighting, due to building being older and under codes from 1984. On 3/2/20, LPA conducted an interview with Fire Marshall regarding the lighting for stairwell. Building from 1984 and Fire code for 1982 applies and only indicates lighting for exit sign illumination. During Power outage facility has a back up generator. Facility under rennovations, which would be the time to address an upgrade in stairwell back up lighting/fixture back up lighting to bring up to current code.

Based on record reviews, interviews and information obtained during the course of the investigation it was determined unsubstantiated. Although the above 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 allegations are deemed UNSUBSTANTIATED at this time.

This report was reviewed and discussed with Kiel, Administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Bertha Raygoza	TELEPHONE: (650) 266-8833
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021

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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