435201057-9-6-2022-26-AS-KHOS-CX4GYU-20231030054608

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435201057
Report Date: 09/06/2022
Date Signed: 09/06/2022 05:28:58 PM

Unsubstantiated

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
06/13/2022 and conducted by Evaluator David Marrufo

COMPLAINT CONTROL NUMBER: 26-AS-20220613142208

FACILITY NAME:	SARATOGA RETIREMENT COMMUNITY		FACILITY NUMBER:	435201057
ADMINISTRATOR:	SARAH STEL		FACILITY TYPE:	741
ADDRESS:	14500 FRUITVALE AVENUE		TELEPHONE:	(408) 741-7100
CITY:	SARATOGA	STATE: CA	ZIP CODE:	95070
CAPACITY:	418	CENSUS: 324	DATE:	09/06/2022
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Sandy Narasimhan		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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Facility resident room air conditioning in disrepair

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced complaint investigation visit and met with Sandy Narasimhan, Health Services Director..

On 06/23/2022, the Department received a complaint with the above allegation. LPA Marrufo conducted complaint investigation visits on 06/23/2022, 07/20/2022, as well as today, 09/06/2022. During the investigation, LPA Marrufo interviewed resident R1 and observed R1’s room, including thermostats, conducted telephone interviews with residents R2-R5, witness W1, and conducted in person interviews with staff S1 and Administrator Sarah Stel. LPA Marrufo conducted interviews with residents R1 and R6-R14 and toured their living units and observed their thermostats.

See LIC9099-C for more information. Page 1 of 3.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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 3

Control Number 26-AS-20220613142208

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: SARATOGA RETIREMENT COMMUNITY	FACILITY NUMBER: 435201057
	VISIT DATE: 09/06/2022

NARRATIVE

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LPA Marrufo also obtained copies of the following documents: handwritten notes on R1’s living unit temperature readings taken every 15 minutes, graph of R1’s room temperature reading, Staff Thermostat Check Log taken 08/15/2022, Resident Roster, Invoice for Air Conditioning Unit Replacement dated 02/24/2022, Invoice for Air Conditioning Service dated 06/25/2021, Data Log for temperature in R1’s living unit, photograph of the living room thermostat in R1’s living unit, R1’s Physician Report, and R1’s Appraisal/Needs and Services Plan.

During interview, R1 stated that temperature of the room would not match the temperature set by the thermostat. R1 stated that the temperature would be as much as 4 or 5 degrees warmer or colder at times compared to the temperature set by the thermostat. R1 stated to measure the temperature using both the temperature reading on the thermostat and another thermometer in R1’s possession. During visit, LPA Marrufo observed R1’s thermostat to be set at 73 degrees Fahrenheit with a measurement of the room at 75 Fahrenheit. LPA Marrufo took multiple temperature readings in various locations within R1’s living room, and the temperatures ranged from 90.1 Fahrenheit to 64.4 Fahrenheit.

Administrator Sarah Stel stated during interviews that R1 had previously complained to facility staff regarding the air conditioning unit. Administrator Stel stated that the facility has replaced the air conditioning unit in R1’s living unit to meet R1’s requests.

S1 stated during interview that the air conditioning unit had previously been replaced to address R1’s problems with the noise of the prior unit. S1 stated that the noise levels had been measured at 40 decibels and was measured with a decibel meter. S1 stated that after the new air conditioner unit was installed, there were still variations of the temperature. S1 also stated that a device was placed in the room to measure and record the room temperatures. S1 stated that the recordings during sleeping hours would show no variation in the temperature, and S1 stated that that implied that R1 was adjusting the temperature throughout the day.

Witness W1 stated during interview that the thermostat in R1’s living unit gives a temperature reading within 2 degrees of the set temperature. W1 stated that a 2-degree range is within the manufacture’s specifications. W1 stated that the air conditioning unit is designed to be kept at a constant temperature and is not meant to be regularly adjusted. See LIC909-C for more information. Page 2 of 3.

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 26-AS-20220613142208

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: SARATOGA RETIREMENT COMMUNITY	FACILITY NUMBER: 435201057
	VISIT DATE: 09/06/2022

NARRATIVE

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During telephone interviews, 4 out of 4 interviewed residents stated that their air conditioner worked properly.

During tour of resident rooms and interviews with residents, LPA Marrufo observed that residents R6-R14 had thermostats had a temperature reading the same as the temperature to which the thermostat was set. R6-R14 stated to have had no problems with their thermostats or air conditioning units. Resident R1 stated to have had problems with the room temperature varying 4-5 degrees hotter or cooler than the temperature set by the thermostat.

During visit on 09/06/2022, LPA Marrufo observed R1’s apartment. LPA Marrufo observed that R1’s thermostat at 3:06 PM was set to 71 Fahrenheit and the temperature was 74 Fahrenheit. LPA Marrufo observed that R1’s living unit front door was open, so R1 shut the door. During interview, R1 stated to have two thermostats, one in the living room and one in the bedroom. R1 stated to not use the thermostat in the bedroom and leaves it off. LPA Marrufo observed that the bedroom thermostat Air Conditioning fan was set to Off, the temperature was set to 73 Fahrenheit, and the thermostat measured the temperature at 77 Fahrenheit. LPA Marrufo observed that both bedroom window blinds were lifted up and sunlight was entering the bedroom.

LPA Marrufo then requested R1 to turn on the bedroom thermostat Air Conditioner fan to full power and set the temperature to 71 Fahrenheit. LPA Marrufo requested R1 to lower the blinds on the bedroom windows. Both the living room and bedroom temperatures then had the same settings. At 3:47 PM, LPA Marrufo observed the living room thermostat to measure the room temperature at 73 Fahrenheit and the temperature set to 71 Fahrenheit. The bedroom thermometer was set to 72 Fahrenheit and set to 71 Fahrenheit.

Based on information from interviews conducted with staff, and records reviewed, although the allegation listed above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated.

No deficiencies were cited under California Code of Regulations Title 22

This report was reviewed with Sandy Narasimhan and a copy of the report was provided. Page 3 of 3.

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

LIC9099 (FAS) - (06/04)

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