435294345-7-28-2023-26-AS-KHOS-CWVMBE-20231023092748

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435294345
Report Date: 07/28/2023
Date Signed: 07/28/2023 03:25:44 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
07/20/2023 and conducted by Evaluator Christine Dolores

COMPLAINT CONTROL NUMBER: 26-AS-20230720102657

FACILITY NAME:	WESTMONT OF MORGAN HILL		FACILITY NUMBER:	435294345
ADMINISTRATOR:	JOLIE HIGGINS		FACILITY TYPE:	740
ADDRESS:	1160 COCHRANE RD		TELEPHONE:	(408) 779-8490
CITY:	MORGAN HILL	STATE: CA	ZIP CODE:	95037
CAPACITY:	112	CENSUS: 76	DATE:	07/28/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Jolie Higgins		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility doesn't have a director
Facility doesn't have an activities director
Staff are not assisting resident with making phone calls

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to open the initial complaint investigation. LPA met with Executive Director (ED) Jolie Higgins and Resident Service Director (RSD) Ria Hernandez.

On 07/20/2023, the Department received the complaint regarding the above allegations.

During visit, LPA toured the memory care section. LPA interview 5 staff members. Documents were obtained to include the resident roster, staff schedule for July 2023, staff roster, resident (R1) admission agreement, physician’s report, service plan, and insurance invoices from November 2022 – June 2023.

Based on interview and record review, the facility does have a director who oversees both Assisted Living and Memory Care. The facility also has an activities director for Assisted Living and Memory Care. SEE LIC9099-C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sarah Yip	TELEPHONE: (408) 324-2131
LICENSING EVALUATOR NAME: Christine Dolores	TELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

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

LIC9099 (FAS) - (06/04)

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Control Number 26-AS-20230720102657

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: WESTMONT OF MORGAN HILL	FACILITY NUMBER: 435294345
	VISIT DATE: 07/28/2023

NARRATIVE

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Based on interview, 5 out of 5 staff state the facility has a cell phone that is provided for residents to make telephone calls. Staff (S5) states the cell phone is used to make calls to family along with receive calls from family. LPA observed the cell phone is capable of telephone calls and video calls. Staff (S4) states the staff assist the residents with telephone calls and/or video calls when needed. Telephone calls to family members are not scheduled and based on request of the family member. The residents are able to receive calls anytime throughout the day.

The Department has investigated the above allegations. Based on interview, record review and observation the above allegations are unfounded. An unfounded finding means the allegation is false, could not have happened and/or without a reasonable basis. No deficiencies were cited per California Code of Regulations, Title 22.

This report was reviewed with Executive Director (ED) Jolie Higgins and Resident Service Director (RSD) Ria Hernandez and a copy of the report was emailed to ED and RSD due to technical difficulties.

SUPERVISOR'S NAME: Sarah Yip	TELEPHONE: (408) 324-2131
LICENSING EVALUATOR NAME: Christine Dolores	TELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

LIC9099 (FAS) - (06/04)

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