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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202729
Report Date: 08/28/2024
Date Signed: 08/28/2024 12:03:03 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-20240627164518
FACILITY NAME:SERENITY HOMEFACILITY NUMBER:
435202729
ADMINISTRATOR:MURILLO, JENNIFERFACILITY TYPE:
737
ADDRESS:17390 SERENE DRIVETELEPHONE:
(831) 818-7981
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:4CENSUS: 3DATE:
08/28/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Lucero Rodriguez and David SandhuTIME COMPLETED:
11:50 AM
ALLEGATION(S):
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Facility staff sleeping during night shift.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to deliver the finding for the above allegation. LPA met with Administrator, Lucero Rodriguez and Director of Operations, David Sandhu.

On 06/27/2024, the Department received a complaint alleging that facility’s staff are sleeping during night shifts. There were no specific staff members that were named during the complaint intake.

On 07/01/2024, the initial complaint investigation was conducted.

Documents were obtained to include the resident roster, staff (S1)'s job application, email correspondence, and June 2024 staff schedule. 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 2
Control Number 26-AS-20240627164518
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: SERENITY HOME
FACILITY NUMBER: 435202729
VISIT DATE: 08/28/2024
NARRATIVE
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Throughout the course of this investigation, 7 staff members were interviewed. Based on staff interviews, 6 out of 7 staff members has not observed any staff members sleeping during night shifts. 1 out of 7 staff members state the observation of staff sleeping during NOC shift. Staff states that when it happens he/she would wake up the staff. Staff states there are normally 2 shift staff present during NOC shift.

5 staff members state that they have heard that staff are sleeping during night shift, however, staff did not know who the staff members were. 1 staff member provided a name of an individual that was seen sleeping during the night shift, however the observation happened about 1 year ago. The staff member reported the observation to leadership, and that staff who observed sleeping was talked to.

It was stated that the facility’s company received information from a staff via email, stating that “some people” are sleeping on their shift, but no names were provided. The review of the email dated 06/23/2024, states that the staff “believe” the other NOC shift staff are sleeping through the night and this staff has seen it with their own eyes. No names or dates of the incidents were provided.

1 resident was interviewed. Based on resident interview, resident denied the observation of staff sleeping during the night.

The Department has investigated the above allegation. Based on interviews, observation and record review the above allegation is unsubstantiated. An unsubstantiated finding indicates that although the allegation 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 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 2