Complaint Investigation Report

486803614-4-14-2023-21-AS-CMAZ-CR3MVE-20230420095637

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

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

03/27/2023 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20230327160637

Facility staff refused to take patient back after hospitalization.

Resident is being illegally evicted from the facility.

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. LPA met with TJ Ilagan and discussed the complaint. During the course of this investigation, this Department has reviewed documents and taken witness statements. The following determinations are made: R1 was admitted to a medical facility on 03/25/2025; On or about 03/27/2023, R1 was medically cleared for release and R1's care facility was notified; On 03/28/2023, in conversation with medical social worker, W1, care facility staff indicated refusal to accept R1 back into the care facility and indicated that R1 was evicted from the care facility; R1 remained in the medical facility until 04/04/2023, at which time R1 was placed in an alternate care facility; Care facility has failed to provide proof of filing an unlawful detainer/court order in compliance with H&S 1569.683(a)(4). Based upon statements and documents, the preponderance of evidence standard has been met. Therefore, the allegations are SUBSTANTIATED. The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.