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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 430708817
Report Date: 04/11/2023
Date Signed: 04/11/2023 01:58:18 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/04/2023 and conducted by Evaluator Ryker Heberle
COMPLAINT CONTROL NUMBER: 26-AS-20230404163203
FACILITY NAME:TERRACES OF LOS GATOS, THEFACILITY NUMBER:
430708817
ADMINISTRATOR:BURGOYNE, BRADLEYFACILITY TYPE:
741
ADDRESS:800 BLOSSOM HILL ROADTELEPHONE:
(408) 356-1006
CITY:LOS GATOSSTATE: CAZIP CODE:
95032
CAPACITY:458CENSUS: 274DATE:
04/11/2023
UNANNOUNCEDTIME BEGAN:
09:37 AM
MET WITH:Bradley BurgoyneTIME COMPLETED:
02:03 PM
ALLEGATION(S):
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Resident is being financially abused
INVESTIGATION FINDINGS:
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Licensing Program Analysts Ryker Heberle and Manuel Monter (LPAs) conducted an unannounced complaint investigation regarding the above alegation. LPAs met with facility administrator Bradley Burgoyne (Admin).

During the investigation, LPAs toured the facility, interviewed 4 residents, 2 staff, and 2 witnesses, and reviewed resident files. During interviews with facility residents, 0 out of 4 residents interviewed stated that had been financially abused, 0 out of 4 resident stated that they were aware of others experiencing financial abuse at the facility. 2 out of 4 residents interviewed stated that they interacted with caregiving staff on a regular basis and have never experienced untoward conduct. 1 out of 4 stated that they didn't need receive cargiving services but approved of caregiving services. 1 out of 4 stated that they contracted private caregiving services.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Sarah YipTELEPHONE: (408) 324-2131
LICENSING EVALUATOR NAME: Ryker HeberleTELEPHONE: 714-328-5152
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
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
Control Number 26-AS-20230404163203
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME: TERRACES OF LOS GATOS, THE
FACILITY NUMBER: 430708817
VISIT DATE: 04/11/2023
NARRATIVE
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4 out of 4 residents interviewed managed their own cash resources. Review of resident files indicated that all residents interviewed were able to manage their own cash resources. 4 out of 4 residents interviewed were capable of understanding and answering all questions asked by the department.

2 out of 2 staff members interviewed indicated that they were currently monitoring residents at the facility under suspicion of being financial abused. 1 out of 2 staff interviewed stated that they have personal check-ins with potential victims of financial abuse 3 times a week. 2 out of 2 staff interviewed stated that they have not been able to find proof of financial abuse having occurred within the facility.

In interview with reporting party, allegation of financial abuse has been determined to have been centered around individuals who are not employed by the facility. RP has stated that they do not believe that facility care staff have directly financially abused residents at the facility.

This agency has investigated the complaint allegation listed. Based on interviews, review of records, and observations, the CCLD has found that the complaint allegation is unfounded, meaning that the allegation is false, could not have happened and/or is without a reasonable basis.

This report was reviewed with and signed by Administrator Bradley Burgoyne. A copy of the report was delivered via email due to printer error.
SUPERVISOR'S NAME: Sarah YipTELEPHONE: (408) 324-2131
LICENSING EVALUATOR NAME: Ryker HeberleTELEPHONE: 714-328-5152
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2