Complaint Investigation Report

415601165-11-7-2025-14-AS-ACON-DQ5398-20260107170244

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

10/29/2025 and conducted by Evaluator Audrey Jeung

COMPLAINT CONTROL NUMBER: 14-AS-20251029145313

Staff did not issue an appropriate refund to resident or resident's authorized representative

LPA Jeung met with administrator to discuss refund of pro-rated monthly fee for client #1, who moved out of facility on 4/8/25. LPA also reviewed client file and obtained copies of relevant documents, including proof of delivery of certified mail to son of client #1 on 9/20/25. Receipt of check has been acknowledged by client's daughter. However, the payee is client. Son/DPOA claims that it cannot be cashed and mailed the check back to facility. Administrator denies receiving the check.

Based on records reviewed and information from administrator, this allegation is determined to be unsubstantiated. Although the allegation may have occurred or is valid, there is not enough evidence to prove the alleged violation did or did not occur.