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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435294345
Report Date: 04/22/2021
Date Signed: 04/22/2021 10:31:17 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/25/2019 and conducted by Evaluator Christopher Hopkins-Clarke
PUBLIC
COMPLAINT CONTROL NUMBER: 26-AS-20191125102524
FACILITY NAME:WESTMONT OF MORGAN HILLFACILITY NUMBER:
435294345
ADMINISTRATOR:STEVEN SILACCIFACILITY TYPE:
740
ADDRESS:1160 COCHRANE RDTELEPHONE:
(408) 779-8490
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:112CENSUS: 75DATE:
04/22/2021
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Billy MitchellTIME COMPLETED:
10:40 AM
ALLEGATION(S):
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-Staff locked residents in room
-Staff left resident in soiled bedding for extended period of time
-Staff not meeting residents needs
-Facility smells like urine
INVESTIGATION FINDINGS:
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On 4/22/2021 Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced complaint investigation regarding the above allegations. LPA met with Executive Director Billy Mitchell via tele-visit due to Covid-19 procedures and explained the purpose of the tele-visit.

Regarding the allegations above, LPA's David Marrufo and Karen Taku conducted the investigation, and based on interviews with staff (am/pm shift), residents were never locked in their rooms and never complained about being locked in their rooms. Residents were checked on first thing in the morning and assisted with dressing and toileting, and/or changing of undergarments. If soiled bedding was observed, it's changed immediately. Residents needs are being met, residents are fed three meals a day with snacks in between along with water being served and available throughout the day. Staff throughout the facility has stated that the facility has never smelled like urine.

Report Continued on LIC9099-C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Christopher Hopkins-ClarkeTELEPHONE: 650-266-8822
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2021
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 2
Control Number 26-AS-20191125102524
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: WESTMONT OF MORGAN HILL
FACILITY NUMBER: 435294345
VISIT DATE: 04/22/2021
NARRATIVE
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Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Billy Mitchell. A copy of this report was provided to Billy Mitchell via email, due to COVID-19 precautionary measures, with a "read receipt" to verify the LIC9099 and 9099-C was received. Billy Mitchell is to print out the report and fax a signed copy to LPA at 650-266-8841 or email to LPA at Christopher.Hopkins-Clarke@dss.ca.gov.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Christopher Hopkins-ClarkeTELEPHONE: 650-266-8822
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2