Senior Care Records.

Complaint Investigation Report

Fhar-hiller Street Home, Belmont01/28/2025Licence 415600122

Census6
Date signed01/28/2025 10:20:41 AM
The inspector’s account

415600122-1-28-2025-14-AS-ACON-DDLNN8-20250205093619

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SAN BRUNO RO , 851 TRAEGER AVE., SUITE 360

This is an official report of an unannounced visit/investigation of a complaint received in our office on

01/07/2025 and conducted by Evaluator Komal Charitra

COMPLAINT CONTROL NUMBER: 14-AS-20250107163629

Facility did not report sexual abuse of staff to another staff member to licensing

On January 28, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced complaint visit to deliver findings for the above allegation. LPA met with, House Manager, Flordilita Silva and explained the purpose of the visit.

Regarding the allegation, facility did not report sexual abuse of staff to another staff member to licensing, according to the reporting party, on January 17, 2024, Staff 1 (S1) sexually assaulted Staff 2 (S2) in the facility with the 6 clients present.

Based on interview conducted with the administrator, S2 reported this incident to him on 1/19/2024. Administrator indicated he was unaware that he needed to report this incident to CCLD as none of the clients were involved.

Based on interviews conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties. Report was discussed with House Manager and a copy is provided with appeal rights.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction