317005513-9-13-2023-59-AS-KHOS-CVSLZ4-20230918091119

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005513
Report Date: 09/13/2023
Date Signed: 09/13/2023 11:58:39 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/05/2023 and conducted by Evaluator Sarena Keosavang

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230905135112

FACILITY NAME:	STERLING COURT AT ROSEVILLE		FACILITY NUMBER:	317005513
ADMINISTRATOR:	DEBRA DUVAL		FACILITY TYPE:	740
ADDRESS:	100 STERLING CT		TELEPHONE:	(916) 786-7200
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95661
CAPACITY:	128	CENSUS: 77	DATE:	09/13/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Executive Director: Debra Duval		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff did not properly notify resident's responsible party of rate increase.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced on 09/13/2023 to deliver final finding for a complaint Community Care Licensing (CCL) received on 09/05/2023. LPA met with Executive Director (AED), Debra Duval, and explained the purpose of the visit.

Throughout the course of the complaint investigation the Department conducted interviews and obtained pertinent documents, such as resident's (R1) physician's report, admission agreement, level of care assessments, medication list, and rate increase letter for review.

Continued page LIC-9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Sarena Keosavang	TELEPHONE: (209) 202-9552
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023

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 59-AS-20230905135112

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: STERLING COURT AT ROSEVILLE	FACILITY NUMBER: 317005513
	VISIT DATE: 09/13/2023

NARRATIVE

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According to complainant, the facility had given an immediate rate increase of $1650.00 per month. R1's responsible party (RP) was not given a 60-day notice of rate increase. R1's level of care and care needs had not increased.

The Department requested for written 60-day notice of rate increase from the facility for reivew. According to the rate increase letter, "as of February 1, 2023, your monthly rent will increase to $5000. These changes will be reflected in your advanced billing statement for the month of February 2023. Given the extraordinary increase in labor and other costs – which are directly tied to care and service – we will be implementing increases in level of care and certain ancillary charges."

The Department reviewed R1's admission agreement. R1's admission agreement indicates, "we shall give sixty (60) days' prior written notice to you of any change in the monthly fee, fees for level of care, or in the charges for additional items and services. However, as described in Section VLF, if you begin receiving a different level of care, the rate for the new level of care shall be charged immediately. We will give you written notice of a l eel of care rate increase within 2 business days after providing serves at the new level of care. In the event of a rate increase, we will include with the notice of the increase the reasons for the increase and a general summary of the additional costs that led to the increase."

Interview statement received from ED indicated, the letter was mailed out to all residents responsible party by corporate the first week of November of 2022. LPA confirmed with ED that the address the letter was mailed out to was RP's address. ED stated the facility do not mail out letters certified. Interview statement received from Business Office Manager, Kimberly Craw, indicated rate increase notice was given to all residents in care. Assisting living residents rate increase was effective immediately. Memory care residents rate increase was not effective immediately. Rate increase for memory care was effective once their level of care assessment was done.

Based on the Department’s investigation as stated above, the preponderance of evidence standards has not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted and report provided.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Sarena Keosavang	TELEPHONE: (209) 202-9552
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023

LIC9099 (FAS) - (06/04)

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