Complaint Investigation Report

306006204-4-16-2024-22-AS-AORZ-D4FTND-20240418145235

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 770 THE CITY DR., SUITE 7100

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

04/05/2024 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20240405084807

WILLOW VIEW GARDENS MEMORY CARE & ASSISTED LIVING

Staff did not provide a resident an admission agreement

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to deliver findings on the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

During the course of the investigation, LPA toured the facility, interviewed staff as well as reviewed and obtained pertinent documentation such as admission agreement. Regarding the allegation that staff did not provide a resident an admission agreement, the investigation revealed the following: Resident 1 (R1) admitted into the facility on 02/29/2024 and admission agreement on file at facility is signed and dated by R1 on 02/29/2024. Billing invoice is dated 02/29/2024-03/31/2024. Administrator indicates admission agreement was signed at time of admission on 02/29/2024.

Based on record review and interviews conducted, the allegation is deemed unfounded, meaning the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report was provided to Administrator.