complaint·January 14, 2025

Licensee did not provide a copy of admissions agreement to resident as required. It is the concern of the reporting party, that after requesting a copy of the Admission Agreement (LIC 604A) from the licensee, the licensee has failed to provide a copy to either the resident (R1) or the resident’s legal representative. To investigate the allegation, the LPA interviewed the resident (R1) and the licensee from 11:25 to 01:06 p.m. and requested records pertinent to the investigation. The interview with the R1 revealed that they had signed the LIC 604A and had requested several times from the licensee to provide them with copies of the signed agreement, however, the licensee failed to provide R1 with copies of the agreement. Furthermore, R1 stated that they asked their legal representative to request the copies from the licensee; the legal representative communicated with the licensee via email and text requesting a copy of the LIC 604A and the licensee failed to provide them with a copy as well. The interview with the Licensee revealed that they thought they had given a copy of the LIC 604A to R1. Furthermore, the licensee stated that they probably disregarded the emails from R1’s legal representative because they did not recognize the name. Upon arrival the LPA reviewed the R1’s file and found R1’s file to have a signed and completed LIC 604A. Based on the information obtained through interviews, the licensee did not provide a copy of admissions agreement to resident as required. Therefore, the allegation is deemed Substantiated at this time. Pursuant to Title 22, California Code of Regulations (CCR), and the Health and Safety Code, the following deficiencies were cited (refer to LIC 9099-D). Citations were issued. Exit interview was conducted and a copy of the report and Appeal Rights were issued.