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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 415601127
Report Date: 03/05/2026
Date Signed: 03/05/2026 02:01:48 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
02/27/2026 and conducted by Evaluator Komal Curley
PUBLIC
COMPLAINT CONTROL NUMBER: 14-AS-20260227161900
FACILITY NAME:SERRA HIGHLANDS SENIOR LIVINGFACILITY NUMBER:
415601127
ADMINISTRATOR:SHAYAN GHEISARFACILITY TYPE:
740
ADDRESS:501 KING DRIVETELEPHONE:
(650) 878-5111
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY:120CENSUS: 51DATE:
03/05/2026
UNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Resident Services Director, Anne DasmarinasTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
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9
Staff do not provide adequate food service
INVESTIGATION FINDINGS:
1
2
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5
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13
On March 5, 2026, Licensing Program Analyst (LPA) Komal Curley conducted an unannounced 10-day complaint visit. LPA met with Resident Services Director, Anne Dasmarinas and explained the purpose of the visit.

Regarding the allegation, staff do not provide adequate food service, according to the reporting party, the med-tech requested assistance from the caregiver to check on Resident 1 (R1) who had not eaten his/her breakfast, however the caregiver stated that R1 did not want to get up. According to the reporting party, the med-tech had to go to R1’s room to assess R1 and bring him/her down to the dining room. Furthermore, reporting party stated, R1 was hungry and wanted to go to the dining room.

During the investigation, LPA interviewed R1, staff and reviewed R1's service plan. Based on R1's service plan, R1 is independent for meals and food trays are delivered to his/her room for every meal. According to staff interviewed, R1 eats meals in his/her room because he/she likes to be in his/her room. LPA interviewed R1 who indicated he/she received his/her meal this morning and has not had an issue with meal service. Based on documents reviewed and interviews conducted, the department has determined that although the above allegation may have happened or is valid, there is no a preponderance of evidence to prove the alleged violation did or did not occur, therefore the above allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Komal Curley
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026
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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