306005421-9-6-2023-22-AS-AORZ-CVNUEG-20230914153107

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005421
Report Date: 09/06/2023
Date Signed: 09/06/2023 10:53:13 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
09/25/2020 and conducted by Evaluator Rosie Quiroz

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200925163115

FACILITY NAME:	BELLA MIA CHATEAU, INC (BMC #1)		FACILITY NUMBER:	306005421
ADMINISTRATOR:	VERA, ZENAIDA C		FACILITY TYPE:	740
ADDRESS:	18410 COLVILLE STREET		TELEPHONE:	(714) 227-5766
CITY:	FOUNTAIN VALLEY	STATE: CA	ZIP CODE:	92708
CAPACITY:	6	CENSUS: 3	DATE:	09/06/2023
		UNANNOUNCED	TIME BEGAN:	09:11 AM
MET WITH:	Zenaida Vera, Administrator		TIME COMPLETED:	10:52 AM

ALLEGATION(S):

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-Illegal Eviction
-Residents have to see a house doctor

INVESTIGATION FINDINGS:

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On today's date, Licensing Program Analyst (LPA) Rosie Quiroz made an unannounced visit for the purpose to deliver findings for complaint allegations listed above. LPA Quiroz was greeted and met with Administrator (AD) Zenaida Vera and discussed purpose of today's visit.
On 10/01/2020, LPA Quiroz conducted 10 day visit virtually due to COVID-19 precautionary measures.
Regarding the allegation "illegal eviction," the investigation revealed the following:Resident 1 (R1) was admitted to the facility on 9/08/2018 and moved out of the facility on 10/20/2020 per responsible parties’ request to move to a skilled nursing facility due to higher level of care and financial needs.
Three of three interviewees denied the allegation of “illegal eviction.” Interviews conducted with three of three interviewees concluded (R1) required higher level care needs due to increased behavioral episodes in the nocturnal hours.
CONTINUED...

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Rosie Quiroz	TELEPHONE: (559) 753-4610
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

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-20200925163115

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: BELLA MIA CHATEAU, INC (BMC #1)	FACILITY NUMBER: 306005421
	VISIT DATE: 09/06/2023

NARRATIVE

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CONTINUED....Regarding the allegation, “Residents have to see a house doctor,” the investigation revealed the following: Three of three interviewees denied the allegation indicating residents have the choice of selecting their own attending primary care physician. (AD) Zenaida Vera indicated utilizing a house doctor is beneficial for those residents' responsible parties who are not able to take the residents to their medical appointments. (AD) Zenaida Vera stated "Families prefer house doctors because it's a mobile agency of Nurse Practitioners and Doctors who come to the facility, and we don't have to worry about transportation. it works out better for the residents and their families, because families don't have to worry about coordinating their own time off to take residents to their medical appointments in person, especially during COVID times."

Therefore based on the preponderance of evidence gathered through interviews and documentation review by LPA Quiroz, the allegations: "illegal Eviction,” and “Residents have to see a house doctor,” are deemed UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. This agency has investigated this complaint.

An exit interview was conducted with Administrator Zenaida Vera, and a copy of this report and LIC 811- Confidential Names were provided at exit.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Rosie Quiroz	TELEPHONE: (559) 753-4610
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2023

LIC9099 (FAS) - (06/04)

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