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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347003994
Report Date: 02/20/2025
Date Signed: 02/20/2025 03:51:42 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
01/09/2025 and conducted by Evaluator Angela Hood
COMPLAINT CONTROL NUMBER: 59-AS-20250109103619
FACILITY NAME:AEGIS ASSISTED LIVING OF CARMICHAELFACILITY NUMBER:
347003994
ADMINISTRATOR:TRACY LEHNERFACILITY TYPE:
740
ADDRESS:4050 WALNUT AVETELEPHONE:
(916) 972-1313
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:90CENSUS: 59DATE:
02/20/2025
UNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Melissa Bell, Business Office ManagerTIME COMPLETED:
04:05 PM
ALLEGATION(S):
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-Staff did not issue appropriate refund to resident or resident's authorized representative
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angela Hood arrived at the care home today, February 20, 2025, and met with the Administrator, Tracy Lehner, and Business Office Manager, Melissa Bell, to amend and deliver complaint investigation findings from a visit conducted on January 16, 2025.

During the course of the investigation, LPA conducted interviews and obtained documentation pertinent to the investigation.

Resident (R1) moved out of the care home after residing at the home for 54 days. According to facility's Community Fee Refund Calculation form, R1 is due 60% of their Community Pre-Admission Fee in the amount of $3300. Originally, the facility applied the 60% fee towards R1's remaining rent balance due.

**********************************************Continued on LIC9099-C***************************************************
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Angela Hood
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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 59-AS-20250109103619
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: AEGIS ASSISTED LIVING OF CARMICHAEL
FACILITY NUMBER: 347003994
VISIT DATE: 02/20/2025
NARRATIVE
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However, the Community Pre-Admission Fee is a separate charge than a resident's rent. Facility agrees to refund R1 the 60% Community Pre-Admission Fee, and moving forward will obtain written consent from a resident or responsible party if applying the Community Pre-Admission Fee towards any other remaining balance owed to the facility.

Based on records reviewed and interviews conducted, the preponderance of evidence standards have been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D page.

Exit interview conducted. A copy of report and appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Angela Hood
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20250109103619
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: AEGIS ASSISTED LIVING OF CARMICHAEL
FACILITY NUMBER: 347003994
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/06/2025
Section Cited
CCR
87507(g)(5)(E)(2)(b)
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87507 Admission Agreements (g) Admission agreements shall specify the following: (5) Refund conditions. (E) Preadmission fees shall be refunded according to the following conditions: 2. Unless Section 87507(g)(5)(E)1. applies, paid preadmission fees that are greater than five hundred dollars ($500) shall be refunded to an applicant, resident, or the applicant/resident’s representative in the following manner: b. A refund of at least 60 percent of the preadmission fee in excess of $500 shall be provided if the resident leaves the facility for any reason during the second month of residency.
This requirement is not met as evidenced by:
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Facility agrees to refund R1 60% of the Community Pre-Admission Fee totaling $3,300. Facility will submit a statement of understanding to LPA by the POC due date of 3/6/2025.
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Based on documentation reviewed and interviews conducted, the facility did not refund resident (R1) 60% of their Community Pre-Admission Fee upon moving out of the facility, which 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.
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Angela Hood
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3