415601052-4-18-2024-14-AS-AMEN-D59TS6-20240514145837

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415601052
Report Date: 04/18/2024
Date Signed: 04/18/2024 04:44:54 PM

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
03/05/2024 and conducted by Evaluator Grace Donato

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20240305082355

FACILITY NAME:	SILVER OAKS		FACILITY NUMBER:	415601052
ADMINISTRATOR:	OLLIE VANCE		FACILITY TYPE:	740
ADDRESS:	16 COLEMAN PLACE		TELEPHONE:	(650) 322-2022
CITY:	MENLO PARK	STATE: CA	ZIP CODE:	94025
CAPACITY:	43	CENSUS: 36	DATE:	04/18/2024
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Bernadette Kang		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff did not safeguard residents personal belongings
Staff are not meeting residents needs

INVESTIGATION FINDINGS:

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On 4/18/24, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced complaint investigation visit. LPA met with Resident Care Coordinator, Bernadette Kang and explained the purpose of today's visit.

Regarding the allegation that staff did not safeguard residents’ personal belongings, Reporting party (RP) stated that there have been items that have come up missing in resident’s room.

LPA attempted to interview eleven responsible parties. Five responsible parties mentioned that they don’t have any issue with regards to missing belongings of the residents. F1 mentioned that there hasn’t been any instance where they had problems with items being lost. F4 said that some things tend to get lost but is later found. The other responsible parties weren’t available for interview. F5 also mentioned a tv remote being lost but was found the same day.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: April Cowan	TELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Grace Donato	TELEPHONE: (714) 293-8294
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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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Control Number 14-AS-20240305082355

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SILVER OAKS	FACILITY NUMBER: 415601052
	VISIT DATE: 04/18/2024

NARRATIVE

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Regarding the allegation of staff are not meeting resident’s needs, RP stated that he/she has noticed that the staff don’t spend time with the residents. RP stated that the staff are on their phones a lot and talking to each other a lot instead of giving the residents some attention as some of them are depressed. RP stated that this has been happening for the last six months.

The five responsible parties that were interviewed mentioned that they don’t have problems with the care that their residents receive. F2 stated that there is no issue with care as they do a good job.

LPA also observed during the visit on 03/07/24, that the phones of staff members were surrendered to Resident Care Coordinators office during shifts. No staff have mobile phones on the floor. Staff were also assisting residents during this time. There was an activity happening in the activity room. Staff interact with residents if they need anything or just check and chat with them.

Therefore, based on interviews and observations, the department has determined that 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 allegation is UNSUBSTANTIATED.

Report is reviewed and copy is provided.

SUPERVISOR'S NAME: April Cowan	TELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Grace Donato	TELEPHONE: (714) 293-8294
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC9099 (FAS) - (06/04)

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