306001407-4-28-2023-22-AS-SSAS-CREQ4H-20230501115023

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306001407
Report Date: 04/20/2023
Date Signed: 04/28/2023 10:05:13 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/09/2023 and conducted by Evaluator Jessica Cho

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230209101403

FACILITY NAME:	EMERALD COURT		FACILITY NUMBER:	306001407
ADMINISTRATOR:	DAIZEL C GASPERIAN		FACILITY TYPE:	740
ADDRESS:	1731 MEDICAL CENTER		TELEPHONE:	(714) 778-5100
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	139	CENSUS: 249	DATE:	04/20/2023
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Daizel Gasperian & Kathleen Panganiban		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

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Resident was given an unlawful eviction.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jessica Cho made an unannounced visit to deliver the findings into the above allegation. LPA Cho met with Executive Director (ED) Daizel Gasperian and Assistant Executive Director (AED)/Assisted Living Director (ALD) Kathleen Panganiban and stated the purpose of the visit. During the course of the investigation, LPA obtained and reviewed records pertinent to Resident 1 (R1). Interviews were conducted with R1 and their Responsible Party (RP), staff, AED/ALD, and the ED. The investigation revealed the following:
It was alleged that the resident was given an unlawful eviction. On December 21, 2022, the facility issued a written eviction notice to Resident 1 (R1). Upon review of the eviction notice, the notice documents the date and reason for the eviction. A copy of the notice was provided to the RP on December 21, 2022. A copy was also received by the Department on December 23, 2022 which was within the mandated five-day period. The notice also presents provisions regarding alternative housing and care options, and a statement regarding the resident’s right to file a complaint with the Department along with the contact information to the Department and the Office of the State Long term Care Ombudsman.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2064
LICENSING EVALUATOR NAME: Jessica Cho	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

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 22-AS-20230209101403

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: EMERALD COURT	FACILITY NUMBER: 306001407
	VISIT DATE: 04/20/2023

NARRATIVE

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The eviction notice provides the statement as specified in Health and Safety Code Section 1569.683(a)(4). Furthermore, facility is in compliance with the regulatory requirements outlined in the Title 22 Regulation, Eviction Procedures.

Therefore, this agency has investigated the complaint and based on the interviews conducted and records reviewed, the above allegation is deemed UNFOUNDED. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted with Executive Director Daizel Gasperian and Assistant Executive Director/Assisted Living Director Kathleen Panganiban, and this report and the LIC811 were provided during this visit.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2064
LICENSING EVALUATOR NAME: Jessica Cho	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

LIC9099 (FAS) - (06/04)

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