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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 415600657
Report Date: 04/16/2025
Date Signed: 04/16/2025 03:23:39 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/14/2025 and conducted by Evaluator Jaime Vado
COMPLAINT CONTROL NUMBER: 14-AS-20250314094640
FACILITY NAME:B & B RESIDENTIAL FACILITIES, INC.FACILITY NUMBER:
415600657
ADMINISTRATOR:BULJAN, ANTEFACILITY TYPE:
740
ADDRESS:3824 BERESFORD STREETTELEPHONE:
(650) 345-4095
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:6CENSUS: 6DATE:
04/16/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Administrators Ante and Nediljka BuljanTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
- Unqualified staff are administering medications to residents in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 04/16/2025, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigaiton visit to deliver findings regarding the allegations received. LPA met with administrators Ante and Nediljka Buljan and explained the purpose of today's visit.

During the course of the investigation, LPA conducted interviews, conducted research, and reviewed pertinent documents related to the allegations. According to interviews and documentation reviewed, staff were trained by hospice to administer medication such as morphine to those residents who may need it. Per interviews, R1 was never given morphine during her time at the facility. This allegation unsubstantiated.

Based on these observations, the above allegations are UNSUBSTANTIATED.
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 above allegations are unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Jaime Vado
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2025
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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