216804000-2-14-2024-21-AS-VBEI-D2MQWQ-20240220113219

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 216804000
Report Date: 02/14/2024
Date Signed: 02/14/2024 03:14:52 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/05/2024 and conducted by Evaluator Caitlynn Felias

COMPLAINT CONTROL NUMBER: 21-AS-20240205134542

FACILITY NAME:	COGIR OF SAN RAFAEL		FACILITY NUMBER:	216804000
ADMINISTRATOR:	SUSAN EDWARDS		FACILITY TYPE:	740
ADDRESS:	111 MERRYDALE ROAD		TELEPHONE:	(415) 472-6530
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	70	CENSUS: 49	DATE:	02/14/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Executive Director/Administrator, Susan Edwards		TIME COMPLETED:	03:25 PM

ALLEGATION(S):

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Resident has been issued an unlawful eviction

INVESTIGATION FINDINGS:

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At approximately 1:00PM, Licensing Program Analyst (LPA) Felias arrived unannounced to initiate a Complaint Investigation regarding the above allegation and met with Executive Director/Administrator, Susan Edwards.

During the course of the Investigation, LPA requested and reviewed documents, conducted interviews, and made observations. There is an allegation of an Unlawful Eviction. Reporting Party stated that R1 and their Responsible Party had a verbal agreement with the former company of the facility, Sunrise Senior Living, where they were allowed to pay their rent one month late. This verbal agreement was continued when the facility was taken over by Cogir Senior Living in July 2021. Record Review showed that there is no written agreement between Cogir Senior Living Management and R1 and their Responsible Party agreeing to continuing this verbal agreement.
Continued on LIC9099C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Kimberley Mota	TELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Caitlynn Felias	TELEPHONE: 707-588-5039
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024

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 21-AS-20240205134542

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: COGIR OF SAN RAFAEL	FACILITY NUMBER: 216804000
	VISIT DATE: 02/14/2024

NARRATIVE

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Continued from LIC9099

R1 and their Responsible Party were issued a total of four Eviction Notices on the following dates: 09/08/2023, 09/26/2023, 09/28/2023, and 11/20/2023. R1 and their Responsible Party were also provided with letters from Cogir Senior Living Management on 08/2023, 10/27/2023, and 01/15/2024.

Review of the Eviction Notices showed that the reason for eviction was due to nonpayment of fees. Further review also showed that the notices included the following information required by Title 22 Regulations: the full name of the resident, the address of the facility resident was being evicted from, the licensee’s signature and date, the reasons for the eviction, the effective date of the eviction, resources available to assist the resident in finding alternative housing, information about the resident’s right to file a complaint with Community Care Licensing (CCL), contact information for CCL and the State Ombudsman, and appropriate wording regarding “an unlawful detainer” if R1 were to stay beyond the identified eviction date. R1 and their Responsible Party were also provided with a billing ledger identifying fees and amounts due.

Per Title 22 Regulations, Eviction Procedures 877224(a)(1), it states: "(a) The licensee may evict a resident for one or more reasons listed in section 87224(a)(1) through (5). (1) Nonpayment of the rate for basic services within ten days of the due date."

Based on documents reviewed, interviews conducted, and observations made, this Agency has investigated the above allegation. We have found that the complaint of Unlawful Eviction is Unfounded. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

No Deficiencies Cited during visit.

Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.

SUPERVISOR'S NAME: Kimberley Mota	TELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Caitlynn Felias	TELEPHONE: 707-588-5039
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024

LIC9099 (FAS) - (06/04)

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