Complaint·January 15, 2026

CONTINUED FROM FORM LIC9099 Regarding the allegation that Facility did not give proper notification of eviction, the following has been concluded: On October 10, 2025, facility administrator Faith Rasouli sent an email to the responsible party and attorney-in-fact for former facility resident R1 with the intention to notify the responsible party that R1's assessed care needs were no longer compatible with the care and supervision levels provided at the facility. However, upon review of the message, it was determined that the notice did not include the following elements as required by Section 87224 of the California Code of Regulation on Eviction Procedures: - A copy of the resident’s current service plan. - A list of referral agencies. - The right of the resident or resident’s legal representative to contact the department to investigate the reasons given for the eviction pursuant to Section 1569.35. - The contact information for the local long-term care ombudsman, including address and telephone number. As a result, the allegation is determined to be Substantiated, meaning that the preponderance of evidence standards has been met. A type B deficiency is cited on an attached form LIC9099-D. Administrator Faith Rasouli had to leave the premises before the conclusion of the visit and authorized caregiving staff Johnny Bugtong to sign the report on her behalf. An exit interview was conducted and a copy of this report along with appeal rights was provided to a facility representative. CONTINUED FROM FORM LIC9099 Regarding the allegation that Facility did not notify responsible party regarding resident's health condition , the following has been concluded: Based on staff interviews and a review of text and email communications between staff and R1's responsible party, licensing staff was able to establish a clear pattern of updates and communication regarding R1's health condition and management of the diabetes diagnosis. Administrator was however unable to trace back documentation that a toe infection had effectively been notified ahead of a specialist appointment during which it was additionally evidenced. There is insufficient evidence to corroborate or discard the allegation. As a result, the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred. An exit interview was conducted and a copy of this report was provided to a facility representative. CONTINUED FROM FORM LIC9099 Regarding the allegation that Resident was issued an unlawful eviction , the following has been concluded: Based on interviews with the facility administrator as well as witnesses, it was determined that alternate placement was eventually found in order to better meet resident R1's care needs without resorting to a formal eviction. As a result, the allegation is determined to be Unfounded, meaning that the allegation is false, could not have happened and/or is without reasonable basis. An exit interview was conducted and a copy of the report was provided.