complaint·January 20, 2023

Agreement executed on July 2, 2020 and signed by R1’s spouse and Administrator Imelda Caro, Care Partners Home Care Service Agreement executed on July 2, 2020, Physician's Report, Health Essentials itemized list of equipment provided, R1’s Trust bank statements documenting check number ending in 1561 in the amount of $6000 that posted on July 3, 2020 for payment to the facility as well as a debit card purchase in the amount of $468 payable to Care Partners, Legal documents naming one of R1’s children as the Trustee of R1’s Trust Account, email communication between R1’s family documenting return of the certified letters mailed to Administrator Imelda Caro, and R1’s Official Death Certificate documenting R1’s death on July 3, 2020 at 0613 hours with place of death at Whispering Oaks - Waverly. The investigation revealed the following: R1 was discharged from South Coast Global Medical Center on July 2, 2020 to Whispering Oaks – Waverly on hospice. Four of four individuals interviewed corroborated the allegation. ADMIN Caro could not corroborate the allegation. Per one of R1’s family members, Administrator Caro would not accept R1 into the facility until all documents were signed by R1’s POA and a check for $6000 was made payable to the facility. $1000 of that $6000 was for a preadmission fee. R1’s family stated Administrator Caro never provided them with a written statement describing all costs associated with the preadmission fee charges. The family was then asked to pay an additional $468 with a debit card for additional services to be provided by Care Partners. Furthermore when interviewed, Administrator Imelda Caro stated she had not refunded the family what was due to them following the death of R1 on July 3, 2020. R1 was only at the facility for 12 hours with the family paying $6468 up front. Administrator Imelda Caro could not provide LPA Velazquez with written proof of any refund that was made to the family of R1 nor a written statement describing all costs associated with the preadmission fee charges pursuant to statute and regulation. Based on LPA's observations, interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the following allegation: Licensee failed to provide refund is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D. An exit interview was conducted with Administrator Imelda Caro and a copy of this report along with the appeal rights, LIC 811, LIC 9098 were provided at the time of this visit.