Complaint Investigation Report

075601562-3-16-2022-15-AS-KHOS-CCRM8R-20220322092335

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

04/14/2020 and conducted by Evaluator Daisy Panlilio

COMPLAINT CONTROL NUMBER: 15-AS-20200414112337

On 03/16/22 at 11:15AM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced subsequent complaint visit with administrator to deliver the finding of above allegation. LPA explained the purpose of the visit with administrator (ADM) on the phone who authorized staff (S1) to act on her behalf and sign the reports.

Allegation: Facility failed to issue proper refund

During investigation, reporting party (RP) called Licensing Program Analyst (LPA1) back on 04/20/2020 at 3:30PM and stated that she received the facility refund check of $2700 by hand delivery from local ombudsman on 04/14/2020. Local ombudsman called the facility, picked up the refund check as well as R1's belongings, then delivered them personally to RP on 04/14/2020.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated. No deficiencies cited. Exit Interview conducted and a copy of this report provided via email.