Senior Care Records.

Complaint Investigation Report

KB Care Home, San Jose11/30/2023Licence 435202293

Census5
Date signed11/30/2023 12:12:23 PM
The inspector’s account

On 06/27/2023, 1 staff member was interviewed. Based on interview, the Administrator did not address the resident and the resident’s power of attorney (POA) on the eviction letter. The Administrator states to address the letter to R1’s service coordinator at San Andreas Regional Center (SARC) because the facility’s contract is with the representative's payee SARC, not with R1’s responsible party.

Based on record review, the eviction letter is addressed to R1’s SARC service coordinator. The reason for eviction is challenges of the parent both inside and outside of the home which created a heightened level of disruption with the other residents, which represents a violation of their client rights. The eviction letter does not include specific facts including date, place, witnesses, and circumstances based on Title 22 regulations.

The Department has investigated the above allegation. Based on interview, record review and observation the preponderance of evidence standard has been met, therefore, the above allegation is substantiated. A deficiency is being cited per California Code of Regulations, Title 22. This report was reviewed with Administrator, Kaitlyn Brownell over the telephone. ADM provided verbal consent to allow staff (S1) to sign the report. A copy of the report and appeal rights were provided during visit.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction