415601039-5-8-2024-14-AS-ACON-D7GM4U-20240724091719

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415601039
Report Date: 05/08/2024
Date Signed: 05/08/2024 06:46:07 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SF COASTAL AC/SC, 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
11/27/2023 and conducted by Evaluator Audrey Jeung

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20231127170557

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:	165	CENSUS: 105	DATE:	05/08/2024
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Joan Newman		TIME COMPLETED:	07:00 PM

ALLEGATION(S):

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- Staff do not ensure that resident(s) are adequately fed while in care

INVESTIGATION FINDINGS:

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LPA Jeung interviewed staff.

Based on review of clients' records, observation of boxed meal preparations, and interviews with clients, staff and witnesses, this allegation is determined to be unsubstantiated. Although the allegation may have occurred or is valid, there is not enough evidence to prove the alleged violation did or did not occur.

Dining room serves breakfast from 7 - 9am, lunch 11am - 1pm, dinner 4 - 6pm. For those who receive meals in their rooms, boxed meals are prepared by kitchen staff before regular dining room service, for pick up or delivery by caregivers; breakfast boxes are prepared and ready for delivery between 7 and 7:30 am, lunch boxes from 11 to 11:30am, and dinner boxes between 4:00 and 4:30 pm. Kitchen and dining staff do not work after 6 pm, so prepared food is not available after 6pm.
Client's responsible party was provided with the cell phone number of the culinary services director to report concerns, but has not contacted him when delivered meal was not as ordered.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cara Smith	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Audrey Jeung	TELEPHONE: (650) 266-8891
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SF COASTAL AC/SC, 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
11/27/2023 and conducted by Evaluator Audrey Jeung

COMPLAINT CONTROL NUMBER: 14-AS-20231127170557

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:	165	CENSUS: 105	DATE:	05/08/2024
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Joan Newman		TIME COMPLETED:	07:00 PM

ALLEGATION(S):

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- Facility is charging for services not being rendered to resident in care

INVESTIGATION FINDINGS:

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The complaint alleging that meal services paid for are not provided has been investigated by the Community Care Licensing Division of the CA Department of Social Services, and determined to be unfounded. This means that the allegation could not have happened and/or is without a reasonable basis.
Client #1 receives 3 delivered meals/day, and pays extra for this service. According to business office manager, there is a charge of $6 for each meal delivery, which is $18/day. However, client #1 was afforded a significant discount,
Boxed meals are prepared by kitchen staff before regular dining room service, for pick up or delivery by caregivers; breakfast boxes are prepared and ready for delivery between 7 and 7:30 am, lunch boxes from 11 to 11:30am, and dinner boxes between 4:00 and 4:30 pm. Prior to pick up by caregivers, boxed meals are checked to ensure that contents are as ordered.
Other residents who received delivered meals reported overall satisfaction with the delivery service.
Client's responsible party was provided with the cell phone number of the culinary services director to report concerns, but has not contacted him when client failed to receive timely delivered meals.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Cara Smith	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Audrey Jeung	TELEPHONE: (650) 266-8891
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 2