Complaint Investigation Report

415600855-3-17-2025-14-AS-KHOS-DF3JK3-20250324070625

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SAN BRUNO RO , 851 TRAEGER AVE., SUITE 360

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

03/11/2025 and conducted by Evaluator Murial Han

COMPLAINT CONTROL NUMBER: 14-AS-20250311150516

Licensee did not provide a refund upon resident's death

On March 17, 2025 Licensing Program Analyst (LPA) Murial Han conducted an unannounced 10-day complaint investigation. LPA met with caregiver, Mila De Villa and explained the purpose of today's visit. Caregiver called and informed manager, Amie Flores of LPA's visit.

Regarding to the allegation of- licensee did not provide a refund upon resident's death, the reporting party stated that resident-in-question (R1) passed away on 12/25/2024 and the responsible party has not gotten the refund.

During today's visit, LPA interviewed the manager over the phone and she stated that the Licensee's son is handling the refund and he is planning to refund the money this month. LPA reminded the manager that per Title 22, the refund shall be issued within 15 days after the personal property is removed.

After the investigation, this allegation is substantiated.

Based on interview, during the investigation, the preponderance of evidence standard has been met. Therefore, this allegation was determined to be substantiated. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties.

Report was discussed with caregiver and a copy is provided with Appeal Rights.