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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200734
Report Date: 08/21/2023
Date Signed: 08/21/2023 10:41:49 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/07/2022 and conducted by Evaluator Jill Clancy-Czuleger
COMPLAINT CONTROL NUMBER: 15-AS-20221207141510
FACILITY NAME:JOY SENIOR CENTERFACILITY NUMBER:
019200734
ADMINISTRATOR:MATHARU, GURPREETFACILITY TYPE:
740
ADDRESS:6400 BRENTWOOD BLVDTELEPHONE:
(510) 543-4695
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:18CENSUS: 13DATE:
08/21/2023
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH: Rose Constastino, CaregiverTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff is financially abusing resident
INVESTIGATION FINDINGS:
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On 08/21/2023 at 09:25 AM, Licensing Program Analysts (LPA), J. Clancy-Czuleger arrived unannounced to deliver complaint findings for the above allegations. LPA met with Rose Constastino, Caregiver and explained the reason for the visit. Administrator Gupreet Matharu authorized Rose Constastino, to sign off on the report as he was not able to come to the facility.

During the course of investigation, Department conducted interviews with staff, resident’s family, and reporting party. Records were reviewed and obtained, including audit report. It was alleged that resident’s (R1) bank accounts had been closed and that new bank accounts for R1 had been opened with staff’s (S1) name. The Auditor’s investigation revealed that S1 financially abused R1. According to R1’s Physician’s Report dated 2/19/2020, R1 was non-ambulatory, and only able to manage his cash resources with assistance from the licensee.

Continued on 9099C....
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Jill Clancy-CzulegerTELEPHONE: 510-286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 15-AS-20221207141510
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: JOY SENIOR CENTER
FACILITY NUMBER: 019200734
VISIT DATE: 08/21/2023
NARRATIVE
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...Continued from 9099
According to R1’s physician’s report dated 12/3/2022, R1 had dementia and was unable to manage his own cash resources. According to records, on 10/7/2022, S1 took R1 to Bank of the West and closed R1’s old checking account and savings account. The remaining balance was transferred to a new checking and savings account. S1 used R1’s debit card to make unauthorized purchases. The auditor obtained R1’s bank statements from January 2021 to December 2022 detailing the unauthorized purchases by S1. The transactions included purchases from Amazon, Chevron, ARCO, Safeway Grocery, Walmart, CVS, 7-Eleven, T-Mobile, Costco, Door Dash, Pizza Guy, Optavia Weight Control, Family Pet Care Center etc.

The auditor determined that the total unauthorized purchases on the resident’s card was $31,727.10.

Based on all the information gathered, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiencies are cited per California Code of Regulations, Title 22, Division 6 and Chapter 8 on the attached LIC9099-D.



Exit interview conducted and a copy of this report and Appeal Rights provided.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Jill Clancy-CzulegerTELEPHONE: 510-286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 15-AS-20221207141510
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: JOY SENIOR CENTER
FACILITY NUMBER: 019200734
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/21/2023
Section Cited
CCR
87217(b)
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Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff… This requirement is not met as evidenced by:
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A mandatory meeting will be held at a later date.
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R1’s medical assessment dated 12/3/2022 stated R1 had dementia and was unable to manage his own cash resources. Administrator possessed R1’s debit card but did'nt keep any records of purchases made. Licensee failed to protect R1’s from financial abuse from S1.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Jill Clancy-CzulegerTELEPHONE: 510-286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3