342700499-11-21-2024-27-AS-KHOS-DBMSNT-20241204130204

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700499
Report Date: 11/21/2024
Date Signed: 11/21/2024 03:17:38 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/18/2024 and conducted by Evaluator Vincent Moleski

COMPLAINT CONTROL NUMBER: 27-AS-20241018143750

FACILITY NAME:	ABOUNDING LOVE II		FACILITY NUMBER:	342700499
ADMINISTRATOR:	NONU, JULIE		FACILITY TYPE:	740
ADDRESS:	3801 LAKE TERRACE DR		TELEPHONE:	(916) 547-0206
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95758
CAPACITY:	6	CENSUS: 5	DATE:	11/21/2024
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Julie Nonu		TIME COMPLETED:	03:25 PM

ALLEGATION(S):

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Resident was charged a transportation fee for an errand that resident did not authorize

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to deliver findings this complaint. LPA Moleski met with facility administrator Julie Nonu and explained the purpose of the visit.

This investigation consisted of interviews and record review. LPA Moleski interviewed Nonu, two staff members (S1-S2), a resident (R1), and an ombudsperson.

22 CCR Section 87464(f)(6) identifies arranging transportation to medical and dental appointments as a basic service required to be provided by licensees. 22 CCR Section 87507(g)(3)(A)(1-3) indicates that licensees must identify in their admission agreements the payment rate for all basic services, including transportation to medical and dental appointments. This rate may be charged as a “single fee, such as monthly fee for room, board,” and so forth, or it may be charged with a “corresponding fee schedule for all basic services not included in the single fee,” so long as the admission agreement provides a comprehensive description of these rates. [continued on 9099-C]

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

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 27-AS-20241018143750

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ABOUNDING LOVE II	FACILITY NUMBER: 342700499
	VISIT DATE: 11/21/2024

NARRATIVE

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22 CCR Section 87507 states that admission agreements may specify conditions under which refunds may be provided, except as required by 22 CCR and HSC. R1’s admission agreement indicates that refunds will be granted only when a 30-day notice has been issued to a resident.

R1’s admission agreement clearly indicates that a charge of $150 is levied each time a resident is transported to medical or dental appointments. R1 signed this admission agreement on 10/7/24, and Nonu signed the agreement on 9/23/24. R1 remembered signing the admission agreement and was aware that there were provisions related to fees for transportation services.

In an interview, R1 said that they had wanted to go to a recent medical appointment with S1, however they said they do not make their own appointments. R1 did not voice any concerns with having S1 make their appointments for them. R1 said they wanted to go to this medical appointments because they needed medication. R1 said they also requested S1 to take them to a grocery store after their medical appointment. R1 said they were charged $80 for the transportation service.

In an interview, S1 said that they make appointments for R1 because they provide transportation for many residents and they need to ensure their availability to provide transportation for everyone. S1 said that R1 was aware that S1 made appointments on R1’s behalf, and the resident had voiced no concerns regarding that arrangement. S1 said that the doctor was not present for a follow-up visit for R1 on October 1, but that was the date provided for the appointment. S1 said that they took R1 to run errands upon R1’s request afterward, and S1 charged $80 for the transportation provided. S1 said that they did not receive any medical paperwork from that visit, due to the absence of the physician.

In an interview, Nonu said that R1’s medical appointment was already made prior to R1’s admission to the facility. Nonu confirmed that R1 was charged $80 for transportation to the appointment.

[continued on 9099-C]

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 27-AS-20241018143750

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ABOUNDING LOVE II	FACILITY NUMBER: 342700499
	VISIT DATE: 11/21/2024

NARRATIVE

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According to facility notes, R1 moved in on 9/23/24, but refused to sign the admission agreement until 10/7/24. R1 is self responsible, according to resident records. R1 is not diagnosed with dementia or cognitive impairment, and does not suffer from confusion or disorientation, according to their LIC 602, dated 1/16/24.

The department has determined the following as it relates to the allegation that a resident was charged a transportation fee for an errand that resident did not authorize:

Based on interviews and record review, the above allegation is UNFOUNDED. A finding that the complaint allegation is unfounded means the allegation is false, could not have happened and/or is without a reasonable basis.

No deficiencies were cited regarding this allegation. An exit interview was held and a copy of this report was left with Nonu.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024

LIC9099 (FAS) - (06/04)

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