331880692-3-12-2021-18-AS-NBRN-BZ6NBJ-20210316101911

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880692
Report Date: 03/04/2021
Date Signed: 03/12/2021 07:48:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-26
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/05/2020 and conducted by Evaluator Shaunte Henry

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200605122213

FACILITY NAME:	SENIOR HOPE MANOR		FACILITY NUMBER:	331880692
ADMINISTRATOR:	DIMAGIBA, ROBERT		FACILITY TYPE:	740
ADDRESS:	74115 PORTOLA POINTE		TELEPHONE:	(760) 610-5011
CITY:	PALM DESERT	STATE: CA	ZIP CODE:	92211
CAPACITY:	6	CENSUS: 3	DATE:	03/04/2021
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Bob Dimagiba, licensee/administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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9

Licensee failed to provide a refund

INVESTIGATION FINDINGS:

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5
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13

On 3/4/21 Licensing Program Analyst (LPA) Shaunte Henry conducted a tele-inspection due to COVID-19 in order to conduct an investigation into the above allegation. LPA Henry spoke with licensee Bob Dimagiba and explained the purpose of the tele-inspection.

The investigation consisted of interviews and document review. On 3/28/20, Resident 1 (R1) admitted themself to the facility without a power of attorney (POA) or a responsible party (RP). According to the admission agreement, R1 was responsible for making monthly payments to the facility on the 28th of each month. R1 wrote personal checks dated 3/28/20, 4/28/20 and 5/28/20. R1 passed away on 6/1/20. Interviews revealed there no POA documents prepared and/or notarized. There were no family names listed as next of kin in R1's file. This agency has investigated the complaint allegation. 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. An exit interview was conducted where this report and LIC 811 were discussed with and provided to the licensee via email.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Edna Musoke	TELEPHONE: (951) 248-0336
LICENSING EVALUATOR NAME: Shaunte Henry	TELEPHONE: (951) 217-0236
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2021

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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