Complaint·March 13, 2025

Review of R2’s admission agreement stipulates that three nutritionally balanced meals are to be made available to residents as part of their monthly fee. The agreement includes language that specifies the provision of meals and snacks, as well as the accommodation of special diets if prescribed. The agreement does not clarify whether R2 is under the Independent Living or Assisted Living rate, but it does provide that residents in the Independent Living program are entitled to two meals per day, with a third available for an additional fee. However, review of R2’s ledger revealed that R2 was paying rent for Assisted Living and not Independent Living. Further record review confirms that R2 was living in the assisted living building of the facility. Review of the email correspondence between R2’s responsible party (RP) and facility staff (S1) revealed that on 3/25/2021, RP questioned the charge for an additional meal on 3/11/2021. S1 stated that the charge was for the third meal as part of the Independent Living Program. RP clarified that R2 was in the Assisted Living Program due to an assistance with two activities of daily living (ADL). S1 then stated that R2 was being charged under the Independent Living rate which includes two meals per day and charges for the third meal. Interview with current administrator, Elena Cuevas, revealed that R2 was paying the Independent Living rate when they lived at this facility. It was also noted during the visit on 1/7/2025 that the facility’s admission agreement was updated and there were some changes, especially the verbiage under the meal section which states: " Residents paying the Independent Living rate have access to three (3) nutritionally balanced meals daily as well. Two meals are included with the core service fee and the third is available for an additional fee." This statement was added to the new admission agreement. Additional changes include Under Living Accommodations, the section Electronic Surveillance was added. It was not in the original admission agreement that was initially approved. According to California Code of Regulations, Title 22, Division 6, Chapter 8, Section 87555 under General Food Service Requirement, (b) The following food service requirements shall apply: (1) Where all food is provided by the facility arrangements shall be made so that each resident has available at least three meals per day. This regulation contradicts the facility’s practice of charging for a third meal for resident living under Assisted Living (RCFE), where meals should be included in their basic services. Therefore, the preponderance of evidence has been met and the allegation that staff are not providing basic food services for resident is SUBSTANTIATED. {2 of 4} Allegation: Facility is overcharging resident. An allegation that facility is overcharging Resident R2 for food services, specifically regarding charges for additional meals beyond the core service fee. The investigation into the allegation was based on a review of R2’s invoice, ledger, admission agreement, relevant regulations, and facility staff interviews. Review of invoice records revealed that R2 was a resident at the Assisted Living building of the facility. A review of R2’s invoice reveals that on 3/11/2021 , R2 was charged an additional $12 for a meal. Similarly, on 4/1/2021 , R2 was charged $72 for six additional meals at a rate of $12 each. R2’s ledger, covering the period from February 2021 to March 2023 , shows consistent monthly charges of $3,200 for rent and $280 for care services, which are associated with Assisted Living. Email correspondence between the Responsible Party (RP) and S1 , a facility representative, further clarifies the overcharging issue. On 3/25/2021 , RP questioned the invoice for an additional $12 meal on 3/11/2021 , arguing that R2 was entitled to three meals a day as per the contract. S1 initially explained that the charge was for the third meal, referencing the Independent Living rate, which includes only two meals, with a third meal available for an extra charge. However, RP responded that R2 was enrolled in the Assisted Living program, which should have included three meals per day. On 4/1/2021 , S1 confirmed that R2’s base rent was charged at the Independent Living rate. Furthermore, in an interview with the facility administrator , it was revealed that some residents in the Assisted Living section are being charged under the Independent Living rate, meaning they only receive two meals per day, unless they opt to pay for a third meal. The admission agreement signed by R2 outlines the provision of three nutritionally balanced meals daily as part of the core service fee for Assisted Living residents, with additional meals available for a fee under the Independent Living rate. However, the agreement does not clearly specify whether R2 is classified under the Independent Living or Assisted Living rate. Despite this, the California Code of Regulations, Title 22, Division 6, Chapter 8, Section 87464(f)(3) , mandates that facilities provide a minimum of three meals per day. Therefore, this allegation is SUBSTANTIATED. A finding that the complaint allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. {3 of 4} California Code of Regulations (Title 22, Division 6, Chapter 8) are being cited on the attached LIC-9099D. Failure to correct the deficiency may result in civil penalties. Exit interview was conducted. Administrator refused to sign this report due to not agreeing with the findings. Per administrator, the same complaint was unsubstantiated on 8/25/2022. Per Administrator, they will be appealing this citation. A copy of this report and appeal rights were provided. {4 of 4}