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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005612
Report Date: 03/15/2022
Date Signed: 03/15/2022 01:10:39 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, 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
03/15/2022 and conducted by Evaluator Michelle Reed
COMPLAINT CONTROL NUMBER: 22-AS-20220315075357
FACILITY NAME:LAKEVIEW ELDERLY CAREFACILITY NUMBER:
306005612
ADMINISTRATOR:VESA, SILVIUFACILITY TYPE:
740
ADDRESS:4355 E ELKSTONE AVETELEPHONE:
(714) 974-5660
CITY:ANAHEIMSTATE: CAZIP CODE:
92807
CAPACITY:6CENSUS: 4DATE:
03/15/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Silviu and Anna Vesa TIME COMPLETED:
01:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Administrator failed to issue refund upon the death of resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Michelle Reed made an unannounced visit to the facility to discuss the complaint allegation. Upon arrival, LPA met with Anna Vesa. Administrator Silviu Vesa was contacted and he arrived a short time after LPA. The complaint was investigated and consisted of interviews with Staff, Administrator Silviu Vesa, and witnesses as well as a review of documentation. The following was determined:

Resident #1(R1) was admitted into the facility on 2/10/22 and passed away on 2/18/22. R1's property was picked up by Hospice and the family on 2/21/22. There was a delay by Kaiser to pick up the bed and a portable oxygen tank. Several phone calls were made by the responsible party and the Licensee. They were not picked up until 3/4/22. The responsible party of R1 was charged from 2/25/22-3/4/22 as the bed was not removed. The admission agreement signed by the responsible party states that upon the death of a resident, fees will accrue until all property is removed. Based upon interviews and a review of records, this allegation is unfounded, meaning that the allegation was false, could not have happened and/or are without a reasonable basis. The Department has therefore dismissed the complaint. An exit interview was conducted with Silviu Vesa and a copy of this report was provided.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: Michelle ReedTELEPHONE: (714) 743-4958
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022
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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