complaint·January 5, 2026

Allegation: Staff did not provide authorized representative with a refund after resident passed away. It is alleged the facility agreed to pay a refund, but the facility has not paid a refund for R1's responsible party after R1's death on September 25, 2025, and the removal of R1 personal belongings. Based on interviews conducted, three out of three staff corroborated the allegation. All staff stated that R1 lived in Room 3 and passed away on September 25, 2025. S1 stated R1’s personal belongings were removed on September 25, 2025. S2 and S3 stated that R1’s personal belongings were removed on September 26, 2025. S1 stated they were informed that a refund was not provided and then proceeded to let their supervisor know the situation. S2 and S3 both stated they heard that the facility did not provide a refund to R1. Based on record review, the Admission Agreement dated May 27, 2025, stated R1 was admitted to the facility on May 27, 2025. On page 5 of the Admission Agreement, it stated that anything after 14 days is refundable and will be based on a prorated amount. It is also stated on page 5 that the admission agreement is terminated on the date of the resident’s death and refund schedule remains as mentioned in the admission agreement. The admission agreement stated the responsible party will not be responsible for any charges after the resident’s date of death. The visitor’s log dated on September 25, 2025, lists three visitors on the day R1 passed. There are no future dates of anyone visiting for R1 to pick up their belongings on September 26, 2025, or any future date. An incident report dated October 3, 2025, stated that family and hospice were present at the time R1 passed away. Based on observation, LPA verified that R1 no longer resides at the facility and all of their belongings were removed. Therefore, based on LPA's observations, interviews, and the records reviewed, the preponderance of evidence standard has been met, therefore the following allegation: Staff did not provide authorized representative with a refund after resident passed away is deemed SUBSTANTIATED as per the California Code of Regulations, Title 22, Division 6, Chapter 8. A deficiency is being cited on the attached LIC9099D. Exit interview was conducted, and a copy of the report, LIC9099D, LIC811, and the appeal rights were provided to Administrator Joanna Gomez.