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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336410270
Report Date: 11/22/2022
Date Signed: 11/22/2022 04:16:11 PM

Substantiated


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
03/22/2022 and conducted by Evaluator Tricia Danielson
COMPLAINT CONTROL NUMBER: 18-AS-20220322141019
FACILITY NAME:CHRISTMAS COTTAGEFACILITY NUMBER:
336410270
ADMINISTRATOR:VICTORIA J. SARSONFACILITY TYPE:
740
ADDRESS:330 S. SAN JACINTO STTELEPHONE:
(951) 765-1840
CITY:HEMETSTATE: CAZIP CODE:
92543
CAPACITY:14CENSUS: 13DATE:
11/22/2022
ANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Victoria Sarson, LicenseeTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff mismanaged resident funds
INVESTIGATION FINDINGS:
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Deborah Mullen, Licensing Program Manager and Tricia Danielson, Licensing Program Analyst (LPA) conducted an office meeting with Licensee Victoria Sarson to discuss the findings of a Trust Audit Report (TAR) dated November 16, 2022 conducted by Community Care Licensing (CCL) to investigate the allegation listed above. Regarding the allegation "Staff mismanaged residents funds", it was alleged that staff Laura Suarez misappropriated $30,000 from Resident #1(R1) and made charges to R1's bank account at stores such as Chili's, Victoria Secret, Sephora and as well as other stores. CCL's TAR revealed Suarez submitted Power of Attorney documentation to R1’s credit union and requested a debit card be issued in her name for R1’s checking account. Bank records confirmed that between March 2021 and March 2022 Suarez used the debit card to make $9,813.08 worth of purchases at various stores, $4,003 in ATM cash withdrawals and $17,000 in branch cash withdrawals for a total of $30,816.08. Based on LPA’s observations, interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099 D. An exit interview was conducted and a copy of this report was provided along with Appeal Rights and LIC811- Confidential Names List.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Tricia DanielsonTELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 18-AS-20220322141019
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: CHRISTMAS COTTAGE
FACILITY NUMBER: 336410270
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/22/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
11/23/2022
Section Cited
HSC
1569.269(a)(10)
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1569.269(a)(10) Enumerated rights; severability- (a)Residents of residential care facilities for the elderly shall have all of the following rights:(10)To be free from neglect, financial exploitation...punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement was not met as evidenced by:
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Licensee states S1 will be served a termination notice by close of business 11/23/2022.
Licensee must reimburse R1's family of all misapproprited funds totaling $30,816.08 and submit proof of such refund to CCL by POC due date of 1/22/2023.
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Based on record review, the Licensee did not ensure R1 was free from financial exploitation while under the facility's care. S1 fraudulently utilized R1’s funds for personal use. This poses a potential health, safety and personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Tricia DanielsonTELEPHONE: (951) 565-7254
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2