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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336425566
Report Date: 12/22/2020
Date Signed: 12/26/2020 02:01:38 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
10/16/2019 and conducted by Evaluator Stephanie Torres
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20191016114807
FACILITY NAME:HOVLEY CARE LLCFACILITY NUMBER:
336425566
ADMINISTRATOR:SVETLANA CALAMAROFACILITY TYPE:
740
ADDRESS:40827 HOVLEY COURTTELEPHONE:
(760) 346-3703
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:6CENSUS: 5DATE:
12/22/2020
UNANNOUNCEDTIME BEGAN:
02:11 PM
MET WITH:Svetlana Calamaro, LicenseeTIME COMPLETED:
02:46 PM
ALLEGATION(S):
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Facility failed to provide full refund after resident's death.
Facility failed to provide refund within 15 days.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Stephanie Torres, contacted the facility to deliver the findings of the investigation on the above allegations via telephone due to COVID-19. The LPA identified herself and discussed the purpose of the call with Licensee, Svetlana Calamaro.

Pertaining to the allegation, "Facility failed to provide full refund after resident's death," it was alleged a full refund of $2,804, following the death of Resident One (R1) on August 24, 2019, was not provided to R1's authorized representative. The LPA conducted staff interviews, reviewed records and took copies of pertinent information. According to Licensee Calamaro, a refund was provided to R1's authorized representative in the amount of $2,356 on September 30, 2019. Licensee Calamaro reported $448 was withheld from the refund for property storage and cleaning costs. A copy of the check was observed on file; it was in the amount of $2,356 and addressed to R1's authorized representative. A review of R1's Admission Agreement revealed no clear specification of fees charged for the storage of a resident's personal property following death/transfer or for the
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Reyna Lacey
NAME OF LICENSING PROGRAM ANALYST: Stephanie Torres
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020
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 3
Control Number 18-AS-20191016114807
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: HOVLEY CARE LLC
FACILITY NUMBER: 336425566
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/22/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/29/2020
Section Cited
CCR
87507(g)(3)(C)
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Admission Agreements - Admis. agreements shall specify the following: Payment provisions...: Any fee that is charged prior to/after admission, shall be clearly specified. This requirement was not met, as evidence by: Based on records review, the Licensee did not ensure fees charged after admis. were
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The Licensee stated she would send in a statement indicating regulation section 87507(g)(3)(C) was read and understood.
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clearly specified in the Admis. Agreement for R1. A review of R1's Admis. Agreement revealed no clear specification of fees charged for the storage of a resident's personal property following death/transfer or for the cleaning costs required. This posed a potential personal rights risk to the resident in care.
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Type B
12/29/2020
Section Cited
HSC
1569.652(c)
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Termination of admission agreement upon death of resident; removal of resident’s property; refund of fees paid; notice of contract termination and refunds: A refund of any fees paid in advance covering the time after the resident’s personal property has been removed...shall be issued...within 15 days after
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The Licensee stated she would send in a statement indicating regulation section 1569.652(c) was read and understood.
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the personal property is removed. This requirement was not met as evidenced by: Based on interview and record review, the Licensee did not ensure a full refund was issued within 15 days of the removal of R1's property from the home. This posed a potential personal rights risk to the resident 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.
NAME OF LICENSING PROGRAM MANAGER: Reyna Lacey
NAME OF LICENSING PROGRAM ANALYST: Stephanie Torres
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/22/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20191016114807
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: HOVLEY CARE LLC
FACILITY NUMBER: 336425566
VISIT DATE: 12/22/2020
NARRATIVE
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cleaning costs required. This posed a potential personal rights risk to the resident in care. Therefore, this allegation is deemed SUBSTANTIATED at this time.

Pertaining to the allegation, "Facility failed to provide refund within 15 days," it was alleged a full refund of $2,804, following the death of R1 was not provided to the resident's authorized representative within fifteen days. According to Licensee Calamaro, a refund was provided to R1's authorized representative in the amount of $2,356, on September 30, 2019. It was revealed $448 was illegally withheld, due to unclear specifications of fees in the Admission Agreement on file. Therefore, the allegation is deemed SUBSTANTIATED at this time.

A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. Citations will be issued in accordance with the California Code of Regulations (Title 22, Division 6, Chapter 8 and Health and Safety, Chapter 3.2).

This report was reviewed with Licensee Calamaro; a copy of this report and Appeal Rights were provided via email and receipt of report confirmed.
NAME OF LICENSING PROGRAM MANAGER: Reyna Lacey
NAME OF LICENSING PROGRAM ANALYST: Stephanie Torres
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3