197802426-4-21-2021-28-AS-LHIS-C6UT4K-20210914142405

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197802426
Report Date: 04/21/2021
Date Signed: 04/21/2021 03:25:01 PM

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
04/14/2021 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20210414115053

FACILITY NAME:	BROOKDALE ALHAMBRA		FACILITY NUMBER:	197802426
ADMINISTRATOR:	WENTWORTH, NICOLE D		FACILITY TYPE:	740
ADDRESS:	1 E COMMONWEALTH AVE		TELEPHONE:	(626) 289-3871
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91801
CAPACITY:	150	CENSUS: 71	DATE:	04/21/2021
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Tracey Holder, Executive Director		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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9

Resident is being charge for services not rendered.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan 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 Tracey Holder, the Executive Director.
LPA Chan conducted interviewed with the Executive Director who stated that Resident #1(R1) is not a resident of this facility nor did Resident #1 ever moved in personal belongings at this facility. LPA interviewed Resident #1 who confirmed that an admission agreement was signed for the Brookdale Uptown Whittier facility and have some items stored at that facility, not at Brookdale Alhambra.
This agency has investigated the complaint alleging Resident is being charge for services not rendered. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

A telephonic exit interview was conducted with Tracey Holder and a copy of this report was provided via email for signature.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2021

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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