Complaint Investigation Report

Allegation: Facility did not give refund to resident’s responsible party

During investigation, LPA interviewed reporting party (RP), facility staff (ADM, S1) and reviewed former resident’s (R1) documents. Review of R1’s admission agreement and death report showed he was first admitted at the facility on 10/30/2020 and expired on 03/09/25. RP stated she sent several text messages to ADM and a priority letter with tracking to the facility requesting for a refund on 06/10/25 with no response. RP also stated she donated all of R1’s belongings to the other residents when he passed away on 03/09/25. On 10/22/25 at 11:15 AM, ADM spoke with RP on the phone and both agreed to a final refund amount of $3,477.46. LPA observed ADM mail the refund check to RP during visit. Based on interviews and observations which were conducted, the preponderance of evidence standard has been met and the above allegation(s) that facility did not give refund to resident’s responsible party is substantiated.

Deficiency is cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties .

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