306006131-7-1-2022-22-AS-MSTC-CFWU3C-20220701151316

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006131
Report Date: 05/24/2022
Date Signed: 07/01/2022 12:14:57 PM

Unsubstantiated

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
04/29/2022 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220429083418

FACILITY NAME:	ACERA HEALTH LLC		FACILITY NUMBER:	306006131
ADMINISTRATOR:	CHOI, JOSEPH		FACILITY TYPE:	772
ADDRESS:	601 DAHLIA AVE		TELEPHONE:	(949) 378-7982
CITY:	CORONA DEL MAR	STATE: CA	ZIP CODE:	92625
CAPACITY:	6	CENSUS: 0	DATE:	05/24/2022
		UNANNOUNCED	TIME BEGAN:	09:54 AM
MET WITH:	Melody Stone		TIME COMPLETED:	10:55 AM

ALLEGATION(S):

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Unlicensed: False Claims/Holding Selves out to have a license and provide services.

INVESTIGATION FINDINGS:

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The investigation into the allegation, unlicensed: false claims/holding selves out to have a license and provide services, revealed the following; The 10-day visit was conducted on 5/6/2022 by LPA Joseph Alejandre. LPA did not observe any occupants, and no one answered the door when the LPA knocked on the door. LPA waited 15 minutes and went to the corporate headquarters of Acera Health LLC and met with Outpatient Program Director Maily Gouger. Outpatient Program Director Gouger reported that no one is currently residing at the facility and the facility is not being used in any capacity at this time. LPA Alejandre requested they go to the facility to verify no one is currently residing there. Outpatient Program Director Gouger and LPA Alejandre went to the facility. LPA observed the facility is furnished but the house had no occupants. LPA and the Outpatient Program Director toured the facility, LPA checked each room and opened all doors and cabinets and storage areas. LPA did not observe any items other than furniture. There were no clothes, food, cleaning supplies, toiletries or personal belongings of any kind at the facility. It was alleged that the facility was in violation of Title 22 regulations 80012 False Claims, 80011 Advertisements and License Number and 80005 License Required.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022

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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Control Number 22-AS-20220429083418

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: ACERA HEALTH LLC	FACILITY NUMBER: 306006131
	VISIT DATE: 05/24/2022

NARRATIVE

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Centralized Applications Bureau determined the following as part of the investigation; the regulations 80012, 80011 and 80005 apply to general licensing and are not applicable to Social Rehabilitation Facilities. Title 22, 81012 False Claims , 81011 Advertisements and License Number and 81005 License Required are the applicable regulations concerning the allegation listed in the complaint. It was reported that on April 14, 2022 Acera Health LLC held an open house at 2329 Purdue Drive Costa Mesa. At the open house Acera Health provided each attendee a brochure and flyer. Regarding, Title 22 81005(a), The referenced brochure and flyer do not list any language that implies that Acera Health was providing services to clients or was licensed at the time of the open house held on 4/14/2022. Regarding, Title 22 81011, this regulation only applies to licensed facilities. Acera Health at 601 Dahlia, Corona Del Mar is not a licensed facility, it is not a requirement to list the facility number on the brochure and flyer. Applicant and CEO of Acera Health Melody stone reported that; each attendee was advised that Acera Health was not yet licensed, nor were they providing services at any of the pending Social Rehab Facilities. Melody Stone stated that the brochure lists the types of services provided by Acera Health as well as treatment programs. Melody Stone added that Acera Health has an outpatient program that provides multiple levels of care and the brochure references only outpatient and future services. Based on the information gathered, the allegation is deemed unsubstantiated, meaning, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted, and a copy of the report provided.

SUPERVISOR'S NAME: Luz Adams	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: (951) 473-7041
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022

LIC9099 (FAS) - (06/04)

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