198600257-10-24-2023-28-AS-RORN-CX5MLP-20231031094241

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600257
Report Date: 10/24/2023
Date Signed: 10/24/2023 03:53:10 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
10/19/2023 and conducted by Evaluator Alma Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20231019161530

FACILITY NAME:	HOUSE OF ST. JOSEPH		FACILITY NUMBER:	198600257
ADMINISTRATOR:	DURHAM, EDMOND F.		FACILITY TYPE:	735
ADDRESS:	2632 WEST 16TH PLACE		TELEPHONE:	(323) 419-0441
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90019
CAPACITY:	15	CENSUS: 4	DATE:	10/24/2023
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Edmond Durham		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility failed to provide refund

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint investigation visit regarding the above allegation(s). LPA met with Administrator Edmond Durham and explained the reason for the visit.

The investigation consisted of the following: LPA Flores requested a copy of Staff and Client rosters. LPA interviewed Administrator Edmond Durham, Staff 1 (S1) and Clients 1-2 (C1-2). C3 was not in the facility at the time of the visit and C4 refused to be interviewed. C5 was not interviewed as they are no longer a client of the facility. LPA reviewed C1-5's files and collected copies of documents pertinent to the investigation. LPA attempted phone calls to Witness 1-2 (W1-2).

(See LIC9099C for continuation)

Substantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

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 28-AS-20231019161530

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: HOUSE OF ST. JOSEPH	FACILITY NUMBER: 198600257
	VISIT DATE: 10/24/2023

NARRATIVE

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Investigation revealed the following: Regarding allegation, Facility failed to provide refund, it is alleged that the facility is closing at the end of October 2023 and that it was reported that the facility has failed to provide a refund for unused days to some clients. As of 10/19/23, four clients were relocated. Interview with Administrator Durham revealed that the facility is closing at the end of the month. He stated that he informed all clients and their responsible parties (if any) on September 19, 2023 of the facility closure. He stated that on as of 10/16/23, four clients had been relocated with the assistance of VA Community Residential Care Placement Coordinator. He stated that he was in communication with C5's Conservator, who had requested a partial refund for C5's rent on 10/19/23 via text. Administrator Durham stated that he will refund any owed monies to any client that is owed money and that at the moment he had not issued any refunds to any client that had left or to their responsible parties. He stated that at the moment his focus is ensuring that all clients are properly placed as the facility is due to close on 10/27/23 and once he has placed all clients he will refund anything prorated amounts that are owed to any client. C5 was not interviewed as they are no longer a client of the facility. LPA attempted phone calls to W1-2. LPA reviewed client's admission agreements which did not indicate if the total monthly rate set forth on the admission agreement would or would not be prorated on a daily basis upon the client's admission to or permanent departure from the facility during the month.

Based on interviews conducted with facility staff and LPA review of records, the preponderance of evidence standard has been met, therefore the above stated allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 1 are being cited on the attached LIC 9099D.

Exit interview held. A copy of the report and appeal rights were provided to Administrator Edmond Durham.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20231019161530

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: HOUSE OF ST. JOSEPH	FACILITY NUMBER: 198600257
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/24/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/27/2023 Section Cited CCR 80068(c)(5)	1 2 3 4 5 6 7	80068 Admission Agreements (c) Admission agreements must specify the following: (5) Refund conditions. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee to submit written Plan of Correction to ensure the facility is meeting Title 22 Regulation. Licensee will provide a refund to C5's responsible party for fees after 10/16/23 for a total of 15 days per prorate and will submit a copy of refund to the department by POC by due date.
	8 9 10 11 12 13 14	Based on document review Licensee did not ensure to indicate on client's admission agreements if the total monthly rate set forth on the admission agreement would or would not be prorated. This poses a potential health and safety risk to clients in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

LIC9099 (FAS) - (06/04)

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