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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602099
Report Date: 04/02/2021
Date Signed: 04/12/2021 11:54:44 AM

Substantiated


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
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/06/2020 and conducted by Evaluator Ulysses Coronel
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20200506121602
FACILITY NAME:CORAL OAKS CARE LIVINGFACILITY NUMBER:
198602099
ADMINISTRATOR:ELEANOR BARRIENTOSFACILITY TYPE:
740
ADDRESS:4271 CARLIN AVETELEPHONE:
(310) 763-4881
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:84CENSUS: 63DATE:
04/02/2021
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sona BhatiaTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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9
Facility mishandles residents' funds
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Ulysses Coronel initiated a complaint investigation for the allegations 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 Sona Bhatia the licensee.

The investigation consisted of the following: On 05/15/2020 LPA Coronel interviewed administrator and conducted a virtual tour of the facility and requested facility and resident records. On 05/18/2020 LPA requested additional facility and resident records. On 06/30/2020 Licensing Program Manager (LPM) Janae Hammond requested the Community Care Licensing Division’s (CCLD) Audit Section to conduct a Trust Audit. On 02/25/2021 CCLD received the Trust Audit Report form General Auditor III (GA3) Jessica Chen. On 03/02/2021 LPA reviewed the Trust Audit Report and Attachments.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
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 5
Control Number 11-AS-20200506121602
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
MONTEREY PARK, CA 91754
FACILITY NAME: CORAL OAKS CARE LIVING
FACILITY NUMBER: 198602099
VISIT DATE: 04/02/2021
NARRATIVE
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The investigation revealed the following: The details of this allegation state that the facility while acting as a representative payee for some of the residents, are paying themselves several months in advance, and does not provide the residents documentation or notice of what was paid in advance. On 02/25/2021 CCLD's Audit Section concluded the Trust Audit and submitted the findings to the department. During audit CCLD auditor gathered and validated residents R1 through R29’s Admission Agreements (AA), Record of Resident's Safeguarded Cash Resources (LIC405), and facility’s bank records from 01/01/2020 through 10/03/2020. Audit of the said documents indicate, that the facility charged more than the SSI established rate of $1,069.37. And that that the facility charged the residents advanced B&C rents but did not apply the payments to the following months and continued to charge monthly B&C payments in these months. The calculated the money the licensee overcharged residents R1 through R29 total to $37,201.00. R1 was overcharged by $1,236.00, R2 $3,406.00, R3 $167.00, R4 $153.00, R5 $43.00, R6 $45.00, R7 $180.00, R8 $630.00, R9 $4,240.00, R10 $223.00, R11 $605.00, R12 $265.00, R13 $218.00, R14 $143.00, R15 $2,326.00, R16 $1,211.00, R17 $10,783.00, R18 $1,249.00, R19 $147.00, R20 $147.00, R21 $2,583.00, R22 $378.00, R23 $3,520.00, R24 $1,591.00,R25 $1,476.00, R26 127.00, R27 $23.00,R28 $43.00 and R29 $43.00. Trust audit also indicated that the facility acted as the residents’ creditor when the residents received reduced SSI payments due to the facility’s failure to help the residents properly spend down their countable resources as required by SSA. Regarding the allegation:” Facility mishandles residents' funds”, the preponderance of evidence standard has been met therefore the above allegation is found to be substantiated. California Code of Regulations, Tittle 22 are being cited please see LIC 9099D.

An exit interview was conducted. A copy of this report and appeal rights were emailed for signature
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 11-AS-20200506121602
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
MONTEREY PARK, CA 91754

FACILITY NAME: CORAL OAKS CARE LIVING
FACILITY NUMBER: 198602099
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
05/03/2021
Section Cited
CCR
87464(e)
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87464(e)Basic Services. If the resident is an SSI/SSP recipient, then the basic services shall be provided and/or made available at the basic rate at no additional charge to the resident. This requirement was not met as evidenced by:
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The licensee will create a plan outlining steps to reconcile and address overchrages made to residents R1 through R29, Proof of Corrections a re due by POC due date.
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Based on record reviews, the licensee failed to ensure that basic services are provided at no additional costs to SSI/SSP recipients, the facility charged residents R1 through R29 more than the SSI/SSP payment standards which poses a potential risk to the health and safety of residents in care.
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Request Denied
Type B
05/03/2021
Section Cited
CCR
87468.2(a)
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87468.2(a) Additional Personal Rights of Residents in Privately Operated Facilities. In addition ... residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (8) To be free from neglect, financial ...abuse. This requirement was not met as evidenced by:
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The licensee will create a plan outlining steps to provide residents R1 through R29 with documentation or notice of what was paid in advance, Proof of Corrections are due by POC due date.
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Based on record reviews, the licensee failed to ensure that residents are free from financial abuse the facility failed to provide the residents R1 through R29 documentation or notice of advance payments, which poses a potential risk to the health and safety of residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/06/2020 and conducted by Evaluator Ulysses Coronel
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20200506121602

FACILITY NAME:CORAL OAKS CARE LIVINGFACILITY NUMBER:
198602099
ADMINISTRATOR:ELEANOR BARRIENTOSFACILITY TYPE:
740
ADDRESS:4271 CARLIN AVETELEPHONE:
(310) 763-4881
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:84CENSUS: 63DATE:
04/02/2021
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sona BhatiaTIME COMPLETED:
10:00 AM
ALLEGATION(S):
1
2
3
4
5
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7
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9
Residents are not allowed to meet with visitors privately.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Ulysses Coronel initiated a complaint investigation for the allegations 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 Sona Bhatia the licensee.

The investigation consisted of the following: On 05/15/2020 LPA Coronel conducted interviewed administrator and conducted a virtual tour of the facilities common areas, which included the TV room, Conference room, dining room and outdoor patio areas and requested facility and resident records. On 05/18/2020 LPA requested additional facility and resident records. On 03/03/2021 LPA conducted facility record reviews. On 03/05/2021 LPA Coronel interviewed 10 out of 63 residents via facetime video call.

The Investigation revealed the following: On 05/15/2020 LPA conducted a virtual tour of the facility, during the tour the Administrator stated that residents and visitors are allowed to use the facility's TV room, conference room, dining room and outdoor patios.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 11-AS-20200506121602
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
MONTEREY PARK, CA 91754
FACILITY NAME: CORAL OAKS CARE LIVING
FACILITY NUMBER: 198602099
VISIT DATE: 04/02/2021
NARRATIVE
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On 03/05/2021 10 out of 10 residents interviewed denied not being able to meet visitors in private. Resident R3 stated "They let me have visits in the TV room, in the dining room.", R4 stated "There is no set rules aside from wearing masks and social distancing." Regarding the allegation:"Residents are not allowed to meet with visitors privately" Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted. A copy of this report and appeal rights were emailed for signature
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5