336403516-10-1-2020-18-AS-JESL-BZVSNA-20210408140114

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336403516
Report Date: 10/01/2020
Date Signed: 10/01/2020 04:03:28 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 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/22/2020 and conducted by Evaluator Crystal Colvin

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20200922101445

FACILITY NAME:	SUN CITY GARDENS		FACILITY NUMBER:	336403516
ADMINISTRATOR:	TED HOLT		FACILITY TYPE:	740
ADDRESS:	28500 BRADLEY ROAD		TELEPHONE:	(951) 679-2391
CITY:	SUN CITY	STATE: CA	ZIP CODE:	92586
CAPACITY:	74	CENSUS: 55	DATE:	10/01/2020
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Ted Holt - Administrator		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Unlawful eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Crystal Colvin contacted the facility via telephone to deliver findings for the complaint investigation with the above allegation(s). LPA Colvin spoke with Administrator Ted Holt and reviewed the following findings:

Based on review of facility documents and interviews conducted by LPA Colvin, it was determined the resident mentioned does not live at licensed facility. Resident (R1) lives in the independent apartment that are not licensed with this Department. This Department does not have jurisdiction over this area and as a result the allegation was deemed as UNFOUNDED. This agency has investigated the complaint alleging unlawful eviction. 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. We have therefore dismissed the complaint.
An exit interview was conducted with Administrator Ted Holt via telephone and a copy of this report was provided to the Administrator via email. Report with facility representative signature was obtained.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2020

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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