Complaint Investigation Report

List of documents reviewed/obtained Faciltiy Resident Roster (dated 05/23/25), Personne Report LIC 500 (dated 05/12/25), (R1)'s Physician's Report LIC 602A (dated 08/19/24 and 02/12/25), Facility Resident Assessment (dated 04/23/25), Resident Lease Agreement (dated 8/24/24), Personal Rights LIC 603C (dated 08/24/24), 30-Day Notice of Termination of Residency Letter (dated 04/14/25), and Family Council Meetings and Follow-up Email Correspondences (dated 12/25/24, 02/12/25, 02/22/25, 04/08/25, 04/15/25 and 05/06/25) and other pertinent records associated with this investigation.

The complaint alleges that the facility issued an illegal eviction to Resident #1 (R1). It reported that the facility failed to issue a legal eviction because the notice was defective. The notice failed to state any of the five legal reasons for the eviction and failed to provide details required by Title 22 Regulations.

On May 23, 2025, between 09:30 AM and 10:50 AM, the Department interviewed staff members identified as Staff #1 through Staff #3 (S1-S3). Three (3) out of the three (3) staff members confirmed that a 30-Day Notice of Termination of Residency Letter (dated 04/14/25) was issued to Resident #1 (R1) along with the family representative and Community Care Licensing (CCL). According to (S1-S3) this Eviction Notice has now been dismissed as of May 19, 2025.

On May 23, 2025, between 11:00 AM and 11:10 AM, the Department interviewed a resident member identified as Resident #1 (R1). (R1) asserted was completely unaware of any eviction notice that had been issued by the facility staff.

On May 23, 2025, between 9:50 AM and 10:12 AM, the Department interviewed a witness member identified as Witness #1 (W1) the power of attorney for (R1 ). (W1) acknowledged a 30-Day Notice of Termination (dated 04/15/25) was received. (W1) addressed that the Notice of Termination dated April 14, 2025, has been dismissed.

A review of (R1)’s 30-day Notice of Termination Letter (dated 04/15/25) and Fed Ex Receipt (dated 04/15/25) was sent to (R1), family representative, and an email receipt to Community Care Licensing (CCL). The 30-Day Notice of Termination under Title 22 Regulation 87244 Eviction Procedures subsection (d) The licensee shall set forth in the Notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons.