Complaint Investigation Report

197608081-2-1-2022-31-AS-EMIR-CBQVTL-20220217154315

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 21731 VENTURA BLVD., STE. 250

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

01/31/2022 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20220131121000

Facility did not issue refund to resident's POA

Licensing Program Analyst (LPA) Wendell Smith made an unannounced complaint visit to investigate the allegation above. LPA met with the administrator and explained the reason for this visit.

Regarding the allegation it is alleged that resident #1 (R1) moved out and the facility did not refund R1's pre-admission fee. LPA interviewed the administrator regarding this allegation from 1:30-1:45pm. LPA also reviewed R1's admission agreement from 1:45-2:10pm. LPA also interviewed R1's responsible person regarding this allegation. Information from a review of R1's admission agreement found that if the resident has lived in the facility for four or more months, the licensee may, but is not required to make a refund of the preadmission fee. It was noted that R1 lived in the facility from 7/5/21 through 1/13/22 which is more that four months. Based on the information obtained this allegation is deemed Unsubstantiated at this time.