331881480-5-29-2024-18-AS-APEZ-DGPPEV-20250515111547

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331881480
Report Date: 05/29/2024
Date Signed: 05/29/2024 12:39:30 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
05/22/2024 and conducted by Evaluator Javina George

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240522083240

FACILITY NAME:	ARLINGTON RIVERSIDE SENIOR COMMUNITY		FACILITY NUMBER:	331881480
ADMINISTRATOR:	WILLIAMS, MORGAN		FACILITY TYPE:	740
ADDRESS:	4609 ARLINGTON AVE		TELEPHONE:	(951) 462-1025
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92504
CAPACITY:	232	CENSUS: 91	DATE:	05/29/2024
		UNANNOUNCED	TIME BEGAN:	09:07 AM
MET WITH:	Morgan Williams, Executive Director		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Staff is retaliating against resident.
Staff is refusing to accept resident's rent money.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Javina George made an unannounced visit to the facility to commence a complaint investigation in regards to the allegations listed above. LPA met with Executive Director Morgan Williams, where LPA explained the purpose of the visit and the elements of the allegations. The allegations were investigated which included observations, interviews and records review.

On 5/22/24 Community Care Licensing received a complaint alleging staff is retaliating against resident and that staff is refusing to accept resident's rent money. Regarding the allegation of staff is retaliating against Resident #1 (R1). R1 was issued an eviction notice on 1/19/24, per an interview with Executive Director Morgan Williams, an internal review of records was conducted and it was discovered that the facility did not remove R1 from auto pay, and R1s rent payment for the originally signed ACH amount was paid in January 2024. The facility issued a refund January's rent in February 2024. A DEMURRER (tests the legal sufficiency of a pleading complaint) was filed against the unlawful eviction that was dismissed on 4/16/24. Per Morgan after consulting with corporate and the facility's attorney, it was agreed that all the

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

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-20240522083240

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: ARLINGTON RIVERSIDE SENIOR COMMUNITY	FACILITY NUMBER: 331881480
	VISIT DATE: 05/29/2024

NARRATIVE

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necessary credits for any partial payments had been given and that R1 should have the 30 day notice to pay or quit reissued on 5/21/24, as the facility still wants to move forward with the eviction of R1 for the failure to pay rent. Based on interviews and records review the allegation of staff is retaliating against resident is unsubstantiated.

Regarding the allegation of staff is refusing to accept resident's rent money. The facility was reissued a new license as there was a change in ownership. Residents are to sign new contracts but R1 is reported by Executive Director as refusing to do so. Per an interview with R1, R1 believes that they would not qualify for the ALW program, and does not want to be responsible or their loved ones to have to pay anything after their passing after being apart of the program.

In addition the facility under went a change in management in July 2023, R1 was issued a 30 day notice to pay rent or quit. R1 resolved that matter in September 2023. Per Executive Director Morgan all residents were informed via the notice dated 10/1/23 and via town hall meeting that was held in or around August 2023 informing that Arlington will accept and retain residents who are either private pay or ALW program recipients, as the contracts with third party services had been terminated. If the residents that are not apart of the ALW program, and considered to be private pay, would be charged $4,500 which was indicated in the letter on dated 10/1/23 and is what R1 was expected to pay beginning 1/1/24. R1 opted to sign up for auto pay to have their rent automatically drafted/paid in September 2023. R1s rent payment for the originally signed ACH amount was paid in January 2024. The facility issued a refund for the amount that was paid in February 2024.

The facility is not accepting R1s rent as R1 is not paying the expected amount based on being defined as a private pay resident. Based on interviews and records review the allegation of Staff is refusing to accept resident's rent money. is unsubstantiated. A finding that the complaint 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(s) occurred.

An exit interview was conducted and a copy of this report was provided to Morgan Williams, Executive Director.

SUPERVISORS NAME: Tricia Danielson
LICENSING EVALUATOR NAME: Javina George
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC9099 (FAS) - (06/04)

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