complaint·November 6, 2024

Regarding the allegations: 1.) Staff did not provide responsible party with a copy of resident's admissions agreement. 2.) Staff did not provide responsible party with a copy of resident's facility file. On 07/11/2023, the Department received a complaint alleging the Licensee failed to provide copies of R1’s documents including admission agreement to R1’s responsible party. Interview with the Licensee confirmed that R1’s responsible person requested R1’s file, however the Licensee attempted to reach out to R1’s responsible person but couldn’t contact them. The Licensee explained that R1’s responsible person moved, and the Licensee no longer has the correct mailing address to send the documents. The Licensee stated that he will attempt further to contact R1’s responsible party to send R1’s file and admission agreement. Based on record review and interviews, the preponderance of evidence standard has been met, therefore the above allegations are deemed Substantiated. Per the California Code of Regulations, Title 22, Division 6, Chapter 8, the following deficiency were observed and cited during the visit (See 9099-D). Exit interview conducted. A copy of the report and appeal rights were provided. Regarding the allegation: 3.) Staff did not properly refund responsible party after resident's death. On 07/11/2023, the Department received a complaint alleging an incorrect amount of refund after Resident #1’s (R1’s) death was issued to R1's responsible party. Per record review, R1 died on 01/04/2023 and prior to R1’s death, R1’s responsible party paid $3,500 for the time period of 12/07/2022 to 01/07/2023. Per interview with the Licensee, the Licensee stated that he refunded R1’s responsible party for $1,700. The refunded amount is for 01/04/2023 to 01/07/2023 which is less than $1700 given. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time. Exit interview conducted. A copy of the report was provided.