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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202780
Report Date: 01/10/2025
Date Signed: 01/10/2025 12:19:45 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
10/12/2023 and conducted by Evaluator Grace Donato
PUBLIC
COMPLAINT CONTROL NUMBER: 26-AS-20231012081055
FACILITY NAME:SONNET HILLFACILITY NUMBER:
435202780
ADMINISTRATOR:JASMINE LATUFACILITY TYPE:
740
ADDRESS:429 MERIDIAN AVETELEPHONE:
(408) 731-0019
CITY:SAN JOSESTATE: CAZIP CODE:
95126
CAPACITY:80CENSUS: 46DATE:
01/10/2025
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Dominique FrommoTIME COMPLETED:
11:11 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are not providing resident's records to responsible party.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 1/10/2025, LPA Grace Donato conducted an unannounced complaint investigation visit. LPA met with Health Welness Director (HWD) Dominique Frommo and LPA explained the purpose of the visit.

Regarding the Facility staff are not providing resident's records to responsible party, RP stated that he/she is asking for the medication administration record and they are not providing it. They're only providing a list of R1s medication. RP asks the nurse for records of R1s fall but they're not providing it. They're not giving the incident reports.

LPA was able to obtain email correspondence between management and RP. The records requested were provided to RP.

Based on records review, the department has determined that that the allegation was false, could not have happened and/or is without a reasonable basis, therefore the allegation is UNFOUNDED.

Report is reviewed and copy is provided.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Grace Donato
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
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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