331880776-3-13-2023-18-AS-JESL-CRBVEN-20230428162237

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880776
Report Date: 03/13/2023
Date Signed: 03/13/2023 12:43:04 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, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/06/2023 and conducted by Evaluator Jesse Gardner

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20230306132940

FACILITY NAME:	WESTMONT VILLAGE		FACILITY NUMBER:	331880776
ADMINISTRATOR:	VIVIAN VILLEGAS		FACILITY TYPE:	740
ADDRESS:	17050 ARNOLD DRIVE		TELEPHONE:	(951) 697-2100
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92518
CAPACITY:	225	CENSUS: 168	DATE:	03/13/2023
		UNANNOUNCED	TIME BEGAN:	11:04 AM
MET WITH:	Vivian Villegas, Administrator		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Illegal eviction issued to resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jesse Gardner made an unannounced visit to initiate an investigation into the above allegation. LPA met with Administrator, Vivian Villegas (S1), who was informed of the purpose of the visit. LPA collected documentation, and conducted a tour of the facility.

It was alleged that Resident #1(R1) was evicted from the facility and the facility was going to put a lock on R1's door at 30-days. Interviews conducted with Administrator Villegas and R1 revealed a written notice of eviction was provided to R1; however, R1's things were still in process of moving out. R1 is independant and had friends move them out of the facility. During a tour of the facility, some of R1's things were still occupying R1's unit. S1 is still working with R1's friends for R1 to obtain their belongings.

Continued on LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Jesse Gardner	TELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023

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 18-AS-20230306132940

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: WESTMONT VILLAGE	FACILITY NUMBER: 331880776
	VISIT DATE: 03/13/2023

NARRATIVE

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LPA reviewed the documentation provided of the eviction notice that was served to Resident #1 (R1) and the contents of the eviction letter and found that the reasoning for the eviction was valid due to non-payment of rent. R1 is currently in the hospital and plans to re-locate to a Skilled Nursing Facility when discharged. The copy of the 30-day notice to quit is in compliance with Health and Safety code §1569.683.

Based on interviews conducted and records reviewed, there is not a preponderance of evidence to prove the alleged violation occurred. Thus, this complaint is Unsubstantiated.

An exit interview was conducted where a copy of this report was discussed with and provided.

SUPERVISOR'S NAME: Deborah Mullen	TELEPHONE: (951) 248-0313
LICENSING EVALUATOR NAME: Jesse Gardner	TELEPHONE: (951) 205-2683
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023

LIC9099 (FAS) - (06/04)

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