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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306002255
Report Date: 05/12/2025
Date Signed: 05/12/2025 04:07:53 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
06/06/2023 and conducted by Evaluator Bethany Moellers
COMPLAINT CONTROL NUMBER: 22-AS-20230606135122
FACILITY NAME:COVINGTON, THEFACILITY NUMBER:
306002255
ADMINISTRATOR:DONALD CASH BENTONFACILITY TYPE:
741
ADDRESS:3 PURSUITTELEPHONE:
(949) 389-8500
CITY:ALISO VIEJOSTATE: CAZIP CODE:
92656
CAPACITY:343CENSUS: DATE:
05/12/2025
UNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Donald Cash Benton, Administraor TIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility did not issue a refund to former resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On today's date, Licensing Program Manager (LPM) Bethany Moellers delivered complaint findings of the above allegation to Administrator, Donald Cash Benton. The findings were delivered via phone and emailed for signature.
The reporting party (RP) alleges facility did not issue a refund to former resident (R1). Based on LPMs interviews conducted and records obtained a refund has been issued per signed admission agreement. R1 moved out of the facility June 2021 and was issued 90% of the entrance fee within fourteen days after new resident moved in, as stated under the reoccupancy benefit outlined on pages 16 and 17 of the admission agreement. Interview with RP confirmed amount owed was given and they have no further concerns. Proof of payment received from the facility.
LPM determined that the allegation is UNFOUNDED. A finding of unfounded means that the allegation is either false, could not have happened, and/or is without a reasonable basis.
Exit interview conduct and no citations issued.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Carla MartinezTELEPHONE: (707) 588-5079
LICENSING EVALUATOR NAME: Bethany MoellersTELEPHONE: (707) 588-5040
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025
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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