complaint·January 15, 2026

Allegation: Staff did not provide authorized representative with a refund after resident passed away. It is alleged the staff would refund part of the money, but the Resident #1 (R1) responsible party never received the refund. R1 moved into the facility on October 1, 2025 and passed away on October 5, 2025. The resident’s belongings were removed out of the facility in October. Based on interviews conducted, five out of five staff and one out of one witness corroborated the allegation. One out of one resident could not confirm or deny the allegation. All staff stated that R1 lived in Room 1 and passed away on October 5, 2025. All staff stated R1’s personal belongings were removed on October 6, 2025. All staff stated they heard that the facility did not provide a refund to R1 in a timely manner. S2 stated that the monthly amount for R1 was $7220. S2 stated the admission agreement stated the monthly amount for $7200 and they did not update the admission agreement for the $20 additional charge for DVR. S2 stated that the facility received and deposited a $3500 but did not deposit a check for the amount of $3720 and voided it. One witness also stated that the facility received an amount of $3500 and the facility did not deposit a check for the amount of $3720. Based on record review, the Admission Agreement dated October 1, 2025, stated R1 was admitted to the facility on October 1, 2025. The additional $20 charge for DVR was not updated on the admission agreement. A text message dated October 4, 2025, stated the DVR will be additional $20 per month. On page 5 of the Admission Agreement, stated on page 5 that the admission agreement is terminated on the date of the resident’s death and refund schedule will be prorated The admission agreement stated the responsible party will not be responsible for any charges after the resident’s date of death. A text message dated on October 6, 2025, at 12:39 PM stated that R1’s belongings were picked up and any remaining items will be removed that same day. A text message dated on October 13, 2025, at 2:39 PM, shows a check dated October 2, 2025, for the amount of $3720 marked “Void.” Based on observation, LPA verified that R1 no longer resides at the facility via the Resident Roster dated December 10, 2025. R1 passed away on October 5, 2025, and all of their belongings were removed from Room 1. Continued on LIC9099C 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. A civil penalty was assessed for a repeated deficiency. Exit interview was conducted, and a copy of the report, LIC9099D, LIC811s, a civil penalty, and the appeal rights were provided to Caregiver Hannah Jose and a copy of the report will be mailed to the corporate address.