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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306001000
Report Date: 01/12/2023
Date Signed: 01/12/2023 03:21:15 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/15/2022 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20221115162302
FACILITY NAME:BROOKDALE VALLEY VIEWFACILITY NUMBER:
306001000
ADMINISTRATOR:DANIEL LINESFACILITY TYPE:
740
ADDRESS:5900 CHAPMAN AVETELEPHONE:
(714) 898-3524
CITY:GARDEN GROVESTATE: CAZIP CODE:
92845
CAPACITY:160CENSUS: 52DATE:
01/12/2023
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Melissa Weibel, Executive DirectorTIME COMPLETED:
03:35 PM
ALLEGATION(S):
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Facility is increasing residents rent without proper notice
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch conducted an unannounced inspection visit to follow up on the investigation of the allegation listed above and deliver findings in the investigation of the allegation. LPA was greeted and granted entry by Executive Director Melissa Weibel after explaining the purpose of the visit and detailing the allegation being investigated at this time.

It was alleged that Facility is increasing residents rent without proper notice. LPA Saborit-Guasch conducted a joint initial complaint investigation visit along with LPA Alvaro Ramirez Jr. on 11/22/2022. A follow-up visit was then conducted on 01/12/2023. During the investigation, the Department interviewed the administrator, the (now former) Health and Wellness Director along with the alleged victim as well as reviewed and obtained pertinent documentation including Progress Notes, Individual Needs and Services assessments and Admission Agreement.

CONTINUED ON FORM LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-GuaschTELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
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 2
Control Number 22-AS-20221115162302
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE & INLAND A/SC, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: BROOKDALE VALLEY VIEW
FACILITY NUMBER: 306001000
VISIT DATE: 01/12/2023
NARRATIVE
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CONTINUED FROM FORM LIC9099

Regarding the allegation that Facility is increasing residents rent without proper notice, the following was concluded: On multiple instances following resident R1's admission to the facility, the Personal Service Rate was reassessed due to documented changes in condition observed in the resident's displayed behavior in the facility. Due to multiple rescheduling of the care conferences during which the rate change is announced, the increased rate billed from 09/06/2022 until 10/30/2022 was charged over one single month, which prompted confusion with resident R1 thinking that the increase was even more substantial than she had been informed.

After the Brookdale Regional Nurse reviewed the previous assessments and reassessed resident R1 on 11/30/2022, the Personal Service Rate was brought back to the initially assessed level. Additional charges due to Behaviors adjustments that had previously been instated were removed effective immediately. A one-on-one meeting between the Executive Director and the resident was held and documented on 12/07/2022 to provide final clarification on the billing. A cost-of-living rate adjustment effective 02/01/2023 was also notified on 11/30/2022, giving the appropriate 60-day notice as indicated in the reviewed Admission Agreement.

Even though facility staff could have made sure to clarify the billing situation with resident, the interviews and records reviewed appear to indicate that adequate notice was given both prior to adjustments to the resident's Personal Service Rate as well as to cost-of-living adjustments to the Basic Service Rate, which was notified 60 days before the effective date.

Based on the evidence gathered during the investigation, the allegation that Facility is increasing residents rent without proper notice is deemed to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. An exit interview was conducted with the facility representative and a copy of this report was left at the facility.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-GuaschTELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2