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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202727
Report Date: 08/28/2024
Date Signed: 08/28/2024 12:06:16 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
06/27/2024 and conducted by Evaluator Christine Dolores
COMPLAINT CONTROL NUMBER: 26-AS-20240627163040
FACILITY NAME:TRANQUILITY HOMEFACILITY NUMBER:
435202727
ADMINISTRATOR:LUCERO RODRIGUEZFACILITY TYPE:
737
ADDRESS:17343 SERENE DRIVETELEPHONE:
(831) 818-7981
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:4CENSUS: 3DATE:
08/28/2024
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Lucero Rodriguez and David SandhuTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Facility staff sleeping during night shift
Drug activity on the premises
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to deliver the finding of the above allegations. LPA met with Adminstrator, Lucero Rodriguez and Director of Operations, David Sandhu.

On 06/27/2024, the Department received the complaint regarding the above allegations. On 07/01/2024, the initial complaint investigation was conducted.

The following documents were obtained to include the resident roster, a staff ’s job application, discussion form, June 2024 staff schedule, email correspondence, and police records.

PAGE 1 OF 2.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: Christine Dolores
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024
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 3
Control Number 26-AS-20240627163040
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: TRANQUILITY HOME
FACILITY NUMBER: 435202727
VISIT DATE: 08/28/2024
NARRATIVE
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Facility staff sleeping during night shift

Based on resident interview, it was stated that sometimes the staff take naps for 1-2 minutes during the night. It was stated that when the lights are off in the office R1 assumes the staff are taking a nap and doesn’t want to bother. No names of the staff were provided. It was stated that there is always someone at the facility if help is needed. It was stated that sometimes R1 wakes up around 1AM and usually see staff are awake.

Based on staff interview, there was 1 staff who was reported to be allegedly sleeping during NOC shift. Staff (S1) state this allegation was from “years” ago. The staff has not observed this whenever he/she comes to the facility unannounced during the night. The staff denied the allegation and is no longer employed at the facility. Due to the reports of staff sleeping during the night shift, the leadership staff are doing nightly unannounced checks and have not physically seen staff sleeping during their shifts.

Drug activity on the premises

1 resident was interviewed. Based on interview, resident has not observed inappropriate behavior with the staff.

Based on staff interview, it was stated that they did let go of a staff who was caught smoking marijuana during their breaktime. It was stated that they did have an incident of staff smelling like marijuana and that staff was sent home and reminded of the company’s drug and alcohol use policy. Staff denied any other incident of staff using drugs or being intoxicated while working.

The Department has investigated the above allegations. Based on interview, record review and observation the above allegations are unsubstantiated. An unsubstantiated finding indicates that although the allegations may have happened and/or is valid there is not a preponderance of evidence to prove the alleged violation did or did not occur. No deficiencies were cited per California Code of Regulations, Title 22.

This report was reviewed with Adminstrator, Lucero Rodriguez and Director of Operations, David Sandhu and a copy of the report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: Christine Dolores
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3