445294156-2-6-2026-26-AS-CKAI-DRDT6J-20260217132709

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 445294156
Report Date: 02/06/2026
Date Signed: 02/06/2026 03:16:51 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
05/02/2025 and conducted by Evaluator Marcella Tarin

COMPLAINT CONTROL NUMBER: 26-AS-20250502135854

FACILITY NAME:	BROOKDALE SCOTTS VALLEY		FACILITY NUMBER:	445294156
ADMINISTRATOR:	KUMAR, BEENA		FACILITY TYPE:	740
ADDRESS:	100 LOCKEWOOD LN		TELEPHONE:	(831) 438-7533
CITY:	SCOTTS VALLEY	STATE: CA	ZIP CODE:	95066
CAPACITY:	220	CENSUS: 157	DATE:	02/06/2026
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Executive Director (ED) Alex Baiasu		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not provide proper transfer assistance to resident in care
Staff did not attend to residents in care in a timely manner
Staff did not ensure resident's room was clean and sanitary
Staff are not following infection control protocol
Staff engaged in verbal argument in front of resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Marcella Tarin conducted a complaint investigation to deliver the complaint findings for the above allegations. LPA met with Executive Director (ED). LPA stated the purpose of the visit.

On 5/5/2025 the Department received a complaint with the above allegations.

On 5/6/2025 the Department interviewed the Reporting Party (RP). RP states he/she observed facility staff transfer a resident, referred to as R1, by ‘bear-hugging’ the resident. RP did not provide additional information regarding this incident.

Page 1 of 4

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026

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 4

Control Number 26-AS-20250502135854

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: BROOKDALE SCOTTS VALLEY	FACILITY NUMBER: 445294156
	VISIT DATE: 02/06/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

On 5/6/2025 and 5/14/2025 the Department conducted complaint investigation visits and interviewed 6 Staff (S1 to S6) and 9 Residents (R1 to R9). 6 Out of 6 Staff stated he/she has had training on transferring residents.

On 5/6/2025 and 5/14/2025 the Department interviewed 9 Residents. 7 Out of 9 Residents state he/she does not require transfer assistance from staff. R1 and R2 state staff help him/her with transfer assistance. R2 states one staff member doesn’t ‘do his/her job very well.’ R2 did not provide additional information regarding this incident.

Review of staff training records from January 2025 to July 2025 to include but not limited to resident rights, resident communication, approach, handling and de-escalation.

Staff did not attend to residents in care in a timely manner
On 5/9/2025 and 5/14/2025 the Department interviewed 6 Staff (S1 to S6). 6 Out of 6 Staff stated he/she attends to residents in care in a timely manner.

On 5/9/2025 and 5/14/2025 the Department interviewed 9 Residents (R1 to R9). 4 Out of 9 Residents state staff attend to him/her in a timely manner. 5 Out of 9 Residents states he/she does not use pendants.

On 5/9/2025 the Department tested R2’s pendant and staff responded in under 5 minutes.

On 5/14/2025 the Department conducted an additional test of pendant response times. R9’s pendant was tested, and staff responded in 3 minutes.

Staff did not ensure resident's room was clean and sanitary
On 5/6/2025 the Department interviewed the Reporting Party (RP). RP states he/she observed R1’s toilet to need a cleaning, and R1's room had an odor.

Page 2 of 4

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 26-AS-20250502135854

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: BROOKDALE SCOTTS VALLEY	FACILITY NUMBER: 445294156
	VISIT DATE: 02/06/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

On 5/9/2025 and 5/14/2025 the Department interviewed 6 Staff (S1 to S6). 6 Out of 6 Staff states resident rooms are cleaned at least once a week by housekeeping. S1 states if he/she observes a resident’s room to have trash on the floor, he/she will pick up the trash. S1 states if he/she observed a toilet in need of cleaning, he/she will inform housekeeping.

On 5/9/2025 and 5/14/2025 the Department interviewed 9 Residents (R1 to R9). 9 Out of 9 residents state staff clean his/her room.

On 5/14/2025, LPA Monter observed 4 random resident rooms as clean, sanitary, odor free, and in good repair.

Staff are not following infection control protocol
On 5/6/2025 the Department interviewed the Reporting Party (RP). RP states he/she observed a staff member change a resident without using gloves and the staff did not wash his/her hands.

On 5/9/2025 and 5/14/2025 the Department interviewed ED. ED states all staff have infection control protocol and wear gloves when caring for residents. ED states he provides this training directly to staff, and ensures staff follow protocol by conducting random checks on staff to ensure staff are wearing gloves and washing hands after caring for a resident.

On 5/9/2025 and 5/14/2025 the Department interviewed 5 Staff (S1 to S5). 5 out of 5 staff state he/she has had infection control protocol training and wear gloves and wash his/her hands before and after caring for residents. S1 states he/she always carries gloves in his/her apron and pulled out gloves to show LPAs during the interview.

On 5/9/2025 and 5/14/2025 the Department interviewed 9 Residents (R1 to R9). 4 Out of 9 Residents states staff wear gloves and staff wash hands when providing care to him/her. 5 Out of 9 staff state he/she does not know if staff wear gloves or wash hands. R3, R4, R5, R6, R7, and R8 state he/she doesn’t pay attention to whether staff are wearing gloves or washing hands.

Page 3 of 4

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 26-AS-20250502135854

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: BROOKDALE SCOTTS VALLEY	FACILITY NUMBER: 445294156
	VISIT DATE: 02/06/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Staff engaged in verbal argument in front of resident
On 5/6/2025 the Department interviewed the Reporting Party (RP). RP states on 4/29/2025 he/she engaged in an argument with staff in front of R1.

On 2/6/2026, the Department interviewed ED. ED states he is not aware of any staff arguing in front of residents at any time.

On 5/9/2025 and 5/14/2025 the Department interviewed 5 Staff (S1 to S5). 5 out of 5 staff state he/she is not aware of any staff arguing in front of residents.

On 5/9/2025 and 5/14/2025 the Department interviewed 9 Residents (R1 to R9). 9 Out of 9 residents state he/she is not aware of any staff arguing in front of residents.

Review of staff training records from January 2025 to July 2025 to include but not limited to topics such as resident rights, resident communication, approach, handling and de-escalation.

This agency has investigated the complaint alleging staff did not provide proper transfer assistance to resident in care, staff did not attend to residents in care in a timely manner, staff did not ensure resident's room was clean and sanitary, staff engaged verbal argument in front of resident. We have found that the complaint was UNFOUNDED meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted with Executive Director (ED) Alex Baiasu and a copy of this report was provided.

Page 4 of 4
END OF REPORT

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 4