Complaint Investigation Report

015601394-10-28-2024-15-AS-KHOS-DAQT3Q-20241105132242

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1515 CLAY STREET, STE. 310

This is an official report of an unannounced visit/investigation of a complaint received in our office on

08/26/2024 and conducted by Evaluator Gregory Clark

COMPLAINT CONTROL NUMBER: 15-AS-20240826122412

Staff did not provide sufficient notice to resident's authorized person of change in use

On 10/28/2024 at 3:30 p.m., Licensing Program Analyst (LPA) Greg Clark arrived to deliver amended findings and report for visit conducted on 9/05/24 in regard to the allegation above. LPA met with Glinda Bertucci, Executive Director and explained the purpose of the visit.

S1 provided LPA with a copy of a letter dated July 17,2024 that was given to residents and families regarding the facility’s plan to relocate the 3rd floor residents to other floors of the facility and de-license the 3rd floor. LPA reviewed the letter and found that the letter was not in compliance with CCL regulations. The letter did not contain many of the required regulatory components for a notice of eviction.

Based on LPA interviews and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D.

Exit interview conducted, a copy of this report and appeal rights provided.