Complaint Investigation Report

107203505-4-8-2026-24-AS-SPIY-DT6L75-20260415082948

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

04/01/2026 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20260401165257

Staff are not accepting resident back at the facility

On 4/08/2026, Licensing Program Analyst (LPA) M. Medina conducted an unannounced initial 10-day complaint visit. LPA arrived, stated purpose of visit, and allowed entrance by direct care staff. Care Coordinator, Shannon Steele contacted by telephone and arrived a short time later to conduct complaint visit with LPA.

During complaint visit, LPA conducted interviews, and received copy of R1's emergency contact sheet. Care Coordinator will e-mail R1's admission agreement and medical assessment. Based on interviews, R1 was ready for discharge from the hospital on 3/24/2026 and was informed by facility on 3/24/26 that R1 could not return due to non-payment of rent. Information provided during interviews from RP indicates R1 has not had a change in condition.

Based on the interviews conducted, the preponderance of evidence standard has been met; therefore, the above allegation is found to be substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D.

An exit interview was conducted with Care Coordinator, Shannon Steele. A copy of this report and appeal rights were discussed and provided. A plan of correction was developed by Care Coordinator and reviewed with LPA.