Complaint Investigation Report

30-Day Notice of Termination of Residency issued to R1 states the following : "The reason(s) for this Notice are as follows: 1. Repeated and/or serious violations of facility house rules and policies pursuant to Title 22 Section 87224. 2. Failure to comply with the terms of the Admission Agreement despite prior discussions and interventions by facility staff. 3. Conduct and behaviors that interfere with the orderly operation of the facility and the well-being, safety, and comfort of staff and other residents."

LPA did not observe any other reasons listed regarding the justification of the eviction on the notice issued to R1 beyond the statement written above. LPA observed that the reasons listed regarding justification of the eviction on the notice issued to R1 did not include specific facts to permit determination of the date, place, witnesses, and circumstances concerning the reasons for eviction. LPA also observed the wrong mailing address used for R1's right to file a complaint with the nearest office of Community Care Licensing.

Based on observations and records reviewed, the preponderance of evidence standards have 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 page.

Exit interview was conducted. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.