197609057-7-22-2020-31-AS-MVAO-BS8MJD-20200806093859

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609057
Report Date: 07/22/2020
Date Signed: 07/22/2020 03:06:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/29/2020 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20200629141602

FACILITY NAME:	PRIMROSE 2		FACILITY NUMBER:	197609057
ADMINISTRATOR:	NAIMUDDIN, MUBEEN		FACILITY TYPE:	740
ADDRESS:	8115 DE SOTO AVE		TELEPHONE:	(323) 387-2755
CITY:	CANOGA PARK	STATE: CA	ZIP CODE:	91304
CAPACITY:	6	CENSUS: 5	DATE:	07/22/2020
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Mubeen Naimudden		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Improper Rent Increase

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Wendell Smith initiated a complaint investigation for the allegation listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Mubeen Naimuddin,
Regarding the allegation above it is alleged that the administrator gave an improper rent increase to residents in care. LPA conducted interviews with the administrator and resident's responsible persons and family members. Information from interviews revealed that in approximately March 2020 the administrator asked resident's responsible parties if they can contribute an extra three hundred dollars a month to help assist the facility with upward cost of paying caregivers to be in the facility more time and for supplies due to COVID-19. Some families were able to assist and some were not. Administrator sent out an invoice for the extra payment and some felt like it was something they had to pay instead of it being voluntary. Administrator stated that it was voluntary and no family had to pay the extra money if they did not want to or could not afford to. Administrator reached out to families and clarified that they did not have to pay anything extra if they did not wish and that no resident's rent was being raised at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell Smith	TELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20200629141602

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: PRIMROSE 2	FACILITY NUMBER: 197609057
	VISIT DATE: 07/22/2020

NARRATIVE

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Based on the information obtained through interviews this allegation is deemed Unsubstantiated at this time. Interviews did reveal that resident's families were asked for the extra money as assistance and the administrator did reach out and clarify to resident families that it was voluntary and if families did not want to pay nothing no one's rent would be raised or any overt action would happen against any resident. A telephonic exit interview was conducted with the administrator and a hard copy was provided via email for signature.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell Smith	TELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2020

LIC9099 (FAS) - (06/04)

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