Complaint Investigation Report

565801851-7-22-2022-29-AS-JAPL-CHD2Z5-20220816174946

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 21731 VENTURA BLVD. #250

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

07/13/2022 and conducted by Evaluator Teresa Camara

COMPLAINT CONTROL NUMBER: 29-AS-20220713130343

Facility did not refund fees paid in advance covering the time after the

Licensing Program Analyst (LPA) Teresa Camara conducted an initial complaint investigation visit regarding the above noted allegtion. LPA met with co-administrator Karina Antig and explained the reason for the visit.

LPA met with the administrator at 12:50 p.m. The administrator indicated the company had their bookkeeper resign unexpectedly and she lost the information needed in order to provide a refund to the decedent's spouse. The administrator confirmed the decedent passed away on 1/17/22 and the spouse removed the decedent's property on 1/18/22. The spouse had paid fees for 1/16/22 - 2/15/22 in the amount of $4,500. Therefore, the licensee owes the spouse the prorated amount of $4,064.48 for 1/19/22-2/15/22.

The above noted allegtion is deemed Substantiated at this time. Pursuant to Title 22 CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D). Exit interview conducted. Today's report and appeal rights were discussed and emailed.