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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320096
Report Date: 02/17/2022
Date Signed: 02/19/2022 09:23:13 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 DR #100
MONTERY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/10/2022 and conducted by Evaluator Lourdes Montoya
COMPLAINT CONTROL NUMBER: 11-AS-20220210143335
FACILITY NAME:BRICKSTONE MANORFACILITY NUMBER:
198320096
ADMINISTRATOR:DADABHOY, MUQEETFACILITY TYPE:
740
ADDRESS:20551 MADISON ST.TELEPHONE:
(310) 251-2382
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY:6CENSUS: 5DATE:
02/17/2022
UNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:DADABHOY, MUQEETTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Licensee is 5 months delinquent on rent
Licensee's lease is expired
INVESTIGATION FINDINGS:
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On 2/17/2022, Licensing Program Analyst (LPA) Lourdes Montoya conducted a 10-day complaint visit at this facility regarding the allegations mentioned above. LPA Montoya called and conducted a risk assessment with Administrator/Licensee Dadhaboy Muqeet at 9:07 am. Soon later, LPA met with Staff Edilberto Bernardino, who assisted with the visit. The purpose of the visit was explained. Licensee arrived later and joined the visit.

The investigation consisted of the following: LPA inquired questions relevant to the nature of the complaint. LPA Montoya conducted a tour of the facility and interviewed the Licensee/administrator. LPA was unable to reach the landlord for interview. LPA requested and obtained copies of the Staff roster (LIC 500), Resident roster (LIC 9020), most recent lease agreement; proofs of monthly rental payments (canceled checks).

Report continued in LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Lourdes Montoya
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
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
Control Number 11-AS-20220210143335
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME: BRICKSTONE MANOR
FACILITY NUMBER: 198320096
VISIT DATE: 02/17/2022
NARRATIVE
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INVESTIGATION REVEALED THE FOLLOWING:

The facility was licensed on 6/3/2020 to serve the elderly, age range 60 and over, six (6) bedridden, hospice waiver for six (6) residents.

Allegation: Licensee is 5 months delinquent on rent.

It is alleged the Licensee is 5 months delinquent on rent. Based on record review, the “Lease Agreement” revealed the lease commenced on 3/12/2020 and continuing thereafter until 3/31/2027. The lease agreement states on Section 4, the monthly rent is $6000.00 payable on the first of each month commencing on 4/1/2020. Section 14 states ”Landlord may, terminate this Agreement and declare a forfeiture of the lease in accordance with California law upon the happening of any of the following events of default: a) rent is not paid within ten (10) days after the due date; or (b) Tenant fails to cure any default in the performance of any covenant of this Agreement within thirty (30) days after written notice thereof; or (c) if the premises become and remain vacant or deserted for a period of thirty (30) days. LPA observed a normal operation of the facility with five (5) residents and three staff on duty. The licensee (tenant) provided LPA with copies of canceled checks for the rental payments proving the licensee (tenant) is not delinquent on the rent.

Allegation: Licensee's lease is expired.

It is alleged the Licensee’s lease is expired. Record review revealed the “Lease Agreement” commenced on 3/12/2020 and continuing thereafter until 3/31/2027. It is written on the lease agreement that the Landlord’s lawyer was present during the signing of the lease agreement. Based on LPA’s review of the lease agreement, the lease is not expired.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations, “Licensee is 5 months delinquent on rent”, and Licensee's lease is expired” did or did not occur, therefore the allegations are Unsubstantiated.



No deficiencies cited, exit Interview conducted, and report given to Licensee/Administrator Dadhaboy Muqeet.

SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Lourdes Montoya
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2