<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197605591
Report Date: 08/25/2022
Date Signed: 11/09/2023 04:05:08 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/02/2022 and conducted by Evaluator Christina Hadley
COMPLAINT CONTROL NUMBER: 28-AS-20220502074202
FACILITY NAME:WESTMINSTER GARDENSFACILITY NUMBER:
197605591
ADMINISTRATOR:ANDREW M SMITHFACILITY TYPE:
741
ADDRESS:1420 SANTO DOMINGO AVENUETELEPHONE:
(626) 358-2569
CITY:DUARTESTATE: CAZIP CODE:
91010
CAPACITY:200CENSUS: DATE:
08/25/2022
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:TIME COMPLETED:
09:36 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Allegation #1 - Facility did not provide a 60 day written notice for rate increases and increases in any rate structure for services as stated in the admission agreement.

INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Interviews conducted and documents reviewed reveal that the community provided written notice for rate increases and rate structures. The annual rate increase letter was provided on November 1, 2021 with new rates effective January 1, 2022. Facility also provided written notice of other rate structures (optional rate fees) including Mr. Milner’s bridge care stay in Assisted Living.

Allegation Finding: Unsubtantiated.

The Department was unable to obtain evidence to support this allegation. A complaint allegation finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Allison NakatomiTELEPHONE: (916) 531-5336
LICENSING EVALUATOR NAME: Christina HadleyTELEPHONE: (916) 651-7853
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/02/2022 and conducted by Evaluator Christina Hadley
COMPLAINT CONTROL NUMBER: 28-AS-20220502074202

FACILITY NAME:WESTMINSTER GARDENSFACILITY NUMBER:
197605591
ADMINISTRATOR:ANDREW M SMITHFACILITY TYPE:
741
ADDRESS:1420 SANTO DOMINGO AVENUETELEPHONE:
(626) 358-2569
CITY:DUARTESTATE: CAZIP CODE:
91010
CAPACITY:200CENSUS: DATE:
08/25/2022
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:TIME COMPLETED:
09:36 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Allegation #2 - Facility did not provide a comprehensive description of the method for evaluating resident's services needs and the fee schedule for the times and services provided.

Facility has provided description of the assessment and education related to the assessment on multiple occasions for both George Milner and Molly Milner. This occurs whenever the assessment is completed. Ms. Milner confirmed that she is in receipt of this information.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Facility has provided description of the assessment and education related to the assessment on multiple occasions for both George Milner and Molly Milner. This occurs whenever the assessment is completed. Ms. Milner confirmed that she is in receipt of this information.

Allegation Finding: Unsubtantiated.

The Department was unable to obtain evidence to support this allegation. A complaint allegation finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Allison NakatomiTELEPHONE: (916) 531-5336
LICENSING EVALUATOR NAME: Christina HadleyTELEPHONE: (916) 651-7853
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2