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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005672
Report Date: 03/24/2023
Date Signed: 03/24/2023 09:38:09 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
03/10/2023 and conducted by Evaluator Jessica Cho
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20230310113304
FACILITY NAME:WELLINGTON, THEFACILITY NUMBER:
306005672
ADMINISTRATOR:THOMAS, JOHNATHANFACILITY TYPE:
740
ADDRESS:24903 MOULTON PARKWAYTELEPHONE:
(949) 458-2311
CITY:LAGUNA HILLSSTATE: CAZIP CODE:
92653
CAPACITY:160CENSUS: 205DATE:
03/24/2023
UNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Gerry VadnaisTIME COMPLETED:
09:50 AM
ALLEGATION(S):
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Staff increased care plan fees without an updated plan.
Facility did not issue resident a refund.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jessica Cho made an unannounced visit to deliver the findings into the above allegations. LPA Cho met with Senior Executive Director (SED) Gerry Vadnais and stated the purpose of the visit. During the course of the investigation, LPA obtained and reviewed records pertinent to Resident 1 (R1) and conducted interviews with Regional Operations Specialist Kathleen Olson and SED. The following was determined:
It was alleged that the care fees increased in the amount of $969.00 in February 2023. Per review of R1’s Resident Assessment, R1’s care plan increased by 13 points in February 2023. The increase in care was to aid with dressing and toileting which was not billed in January 2023. R1 was provided with dressing and toileting services in January 2023 due to a fall on December 16, 2022. As a result, R1 was billed for these services in the February 2023 care plan which then increased in the amount of $247.00 not $969.00.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2064
LICENSING EVALUATOR NAME: Jessica ChoTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
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-20230310113304
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: WELLINGTON, THE
FACILITY NUMBER: 306005672
VISIT DATE: 03/24/2023
NARRATIVE
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It was alleged that the facility did not issue a refund for the care plan from November 2022 to February 2023. Review of the charges and credits on the ledger revealed that legacy care credits were issued since September 2022 in addition to credits related to R1’s care.

Therefore, this agency has investigated the complaint. Based on the interviews conducted and the records reviewed, the above allegations are 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.
SUPERVISOR'S NAME: Sheila SantosTELEPHONE: (714) 334-2064
LICENSING EVALUATOR NAME: Jessica ChoTELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2