Complaint Investigation Report

079200855-9-12-2023-15-AS-KHOS-CW9KRA-20231003080736

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

04/06/2023 and conducted by Evaluator Jill Clancy-Czuleger

COMPLAINT CONTROL NUMBER: 15-AS-20230406080437

Resident in care was charged for services that he is not receiving

On 09/12/2023 at 09:21AM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger arrived unannounced to conduct an unannounced to conduct a complaint visit. LPA explained the purpose of the visit with Siobhan Lehman, Executive Director.

Based on interviews and record reviews, R1 was receiving the level of care that he was paying for. In interviews with both R1 and S1 it was clear that there was a miss communication between them about what services were provided in each level of care. R1’s ledger shows that he did receive a level of care change on 06/02/2023 and the facility did give a concession of $4500 on 07/19/2023.

Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted and a copy of this report provided.