435200950-6-14-2021-26-AS-RMAO-C4NPQR-20210706113135

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435200950
Report Date: 06/14/2021
Date Signed: 06/14/2021 04:27:40 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/26/2020 and conducted by Evaluator Joanne Roadilla

COMPLAINT CONTROL NUMBER: 26-AS-20201026135232

FACILITY NAME:	SORIANO RESIDENTIAL CARE HOME		FACILITY NUMBER:	435200950
ADMINISTRATOR:	SORIANO, MARIA		FACILITY TYPE:	740
ADDRESS:	227 WEST CAPITOL AVENUE		TELEPHONE:	(408) 684-4070
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	6	CENSUS: 3	DATE:	06/14/2021
		UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Maria Soriano		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff refused to provide resident with assistance in using the bathroom.
Food provided by facility is too spicy for consumption.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Joanne Roadilla and Ryker Heberle conducted an unannounced complaint visit to deliver the investigation findings on the above allegations. LPA spoke to Administrator (ADM) Maria Soriano and discussed the purpose of the visit.

On 10/29/20, LPA conducted an initial 10-day investigation tele-visit of the above allegations that happened within August to October 2020. LPA interviewed ADM and staff (S1) and requested for residents’ records.

Subsequent tele-visits via FaceTime were conducted on 02/11/21 where LPA interviewed 3 residents (R1-R3) and between 03/12/21 and 04/30/21 where LPA interviewed ADM, two staff (S2-S3) and 3 residents at the facility. Continued on 9099-C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Romeo Manzano	TELEPHONE: (650) 388-2297
LICENSING EVALUATOR NAME: Joanne Roadilla	TELEPHONE: (408) 205-2348
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2021

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 5

Control Number 26-AS-20201026135232

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: SORIANO RESIDENTIAL CARE HOME	FACILITY NUMBER: 435200950
	VISIT DATE: 06/14/2021

NARRATIVE

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Allegation: Staff refused to provide resident with assistance in using the bathroom.

From staff interviews, 4 out of 4 staff stated that all residents are independent and does not need assistance in using the bathroom.

During resident interviews, 3 out of 3 residents confirmed that they are independent and do not need assistance using the bathroom. Based on observation, all residents are ambulatory and can go to the bathroom unassisted. LPA also observed the passageway to the bathroom was unobstructed.

Allegation: Food provided by facility is too spicy for consumption.

From staff interviews, 4 out of 4 staff stated none of the residents are served with spicy food. Staff stated they only provide them with regular meals where they get their meat, carbohydrates, vegetables and dessert. Staff also stated residents like what they serve and they like their cooking.

From resident interviews, 3 out of 3 residents denied complaining about the food being too spicy for consumption. Residents stated they are served normal food or are provided with something else when they don’t like the food being served.

The department has completed the investigation of the above allegations. Based on staff interview and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis.

No deficiencies cited during today's visit. Report was discussed with and a copy provided to Maria Soriano.

SUPERVISOR'S NAME: Romeo Manzano	TELEPHONE: (650) 388-2297
LICENSING EVALUATOR NAME: Joanne Roadilla	TELEPHONE: (408) 205-2348
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/26/2020 and conducted by Evaluator Joanne Roadilla

COMPLAINT CONTROL NUMBER: 26-AS-20201026135232

FACILITY NAME:	SORIANO RESIDENTIAL CARE HOME		FACILITY NUMBER:	435200950
ADMINISTRATOR:	SORIANO, MARIA		FACILITY TYPE:	740
ADDRESS:	227 WEST CAPITOL AVENUE		TELEPHONE:	(408) 684-4070
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	6	CENSUS:	DATE:	06/14/2021
		UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Maria Soriano		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff made derogatory statements to resident in regard to their race.
Facility has problems with insect infestation.
Staff shouts at resident.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Romeo Manzano	TELEPHONE: (650) 388-2297
LICENSING EVALUATOR NAME: Joanne Roadilla	TELEPHONE: (408) 205-2348
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2021

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

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 26-AS-20201026135232

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: SORIANO RESIDENTIAL CARE HOME	FACILITY NUMBER: 435200950
	VISIT DATE: 06/14/2021

NARRATIVE

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Allegation: Staff made derogatory statements to resident in regard to their race.

From staff interviews, 4 out of 4 staff all stated that staff do not make derogatory comments to the residents about their race.

During resident interviews, 1 out of 3 residents stated they have not heard the staff make derogatory comments about their race. 1 out of 3 residents stated hearing something offensive “maybe 1-2 years ago” but resident was not able to provide additional information. 1 out of 3 residents stated that one of the staff would sometimes make racist statements but that the statements are not directed at any of the residents in particular.

Allegation: Facility has problems with insect infestation.

From staff interviews, 3 out of 4 staff denied the facility to be infested with insects. 2 out of 4 staff stated that the facility had gone through a renovation in 2018 due to cockroach and bed bugs. ADM stated the home is being serviced by a pest control company to make sure they don’t get insects/pests in the home again. ADM also stated that a resident reported about having bed bugs in the room in September 2020. Staff checked the resident and did not see any bug bites on the resident. They also checked the room and did not see bed bugs there, but ADM washed the resident’s bedding anyway.

From resident interviews, 1 out of 3 residents stated they have not seen or noticed any insects or bed bugs in the home. 2 out of 3 residents stated bed bugs are still present at the facility but not as bad as before. 2 out of 3 residents stated they have witnessed the home was sprayed for bed bugs.

Continued on 9099-C.

SUPERVISOR'S NAME: Romeo Manzano	TELEPHONE: (650) 388-2297
LICENSING EVALUATOR NAME: Joanne Roadilla	TELEPHONE: (408) 205-2348
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2021

LIC9099 (FAS) - (06/04)

Page: 5 of 5

Control Number 26-AS-20201026135232

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: SORIANO RESIDENTIAL CARE HOME	FACILITY NUMBER: 435200950
	VISIT DATE: 06/14/2021

NARRATIVE

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Allegation: Staff shouts at resident.

From staff interviews, 4 out of 4 staff stated no one at the facility shouts at the residents. ADM stated she is aware of only one incident where there was shouting involved between a staff and a resident when one of the residents left the TV on during the night and staff had asked the resident about it. Staff stated there may be loud voices sometimes but there are no arguments and that staff are not reprimanding, it’s just the staff’s normal tone of voice.

From resident interviews, 2 out of 3 residents stated there have been an incident where staff shouted at the residents. Resident stated the shouting was due to a miscommunication, but resident do not remember when the incident happened.

The department has completed the investigation of the above allegations. Based on interviews and records review, there is no preponderance of evidence to prove the allegations did or did not occur. Therefore, the Department found the above allegations to be UNSUBSTANTIATED.

No deficiencies cited during today's visit. Report was discussed with and a copy provided to Maria Soriano.

SUPERVISOR'S NAME: Romeo Manzano	TELEPHONE: (650) 388-2297
LICENSING EVALUATOR NAME: Joanne Roadilla	TELEPHONE: (408) 205-2348
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2021

LIC9099 (FAS) - (06/04)

Page: 4 of 5