Complaint Investigation Report

107201592-5-7-2024-24-AS-SMOA-D5QKCN-20240529074723

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

03/07/2024 and conducted by Evaluator Vadim Gorban

COMPLAINT CONTROL NUMBER: 24-AS-20240307104906

Staff overcharging resident for cigarettes.

On 5/07/2024, Licensing Program Analyst (LPA) V. Gorban and Licensing Program Manager (LPM) S. Moua met with Administratr Sundari "Susan" Kendakur and Care Coordinator Jean to discuss the above allegations and deliver findings.

The Department conducted interviews and reviewed records. Based on the records reviewed, the facility failed to provide receipts detailing the breakdown of a carton of cigarettes and how resident’s P&I funds were used to purchase the item. The Department was only provided payment receipts that does not indicate how many cartons and what type of cigarettes were purchased. The ledger provided show discrepancies because the resident was charged $32.75 in 2021, $76.91 in 2023, and then #32.75 in 2023. The preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED.

See citations on the attached LIC. 9099D.