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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374601895
Report Date: 09/20/2023
Date Signed: 09/20/2023 04:11:57 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/19/2023 and conducted by Evaluator Sabel Martinez
COMPLAINT CONTROL NUMBER: 08-AS-20230919120951
FACILITY NAME:JOY & JAY HOME CAREFACILITY NUMBER:
374601895
ADMINISTRATOR:ANA OSBORNEFACILITY TYPE:
740
ADDRESS:12946 AMARANTH STTELEPHONE:
(858) 240-7883
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY:6CENSUS: 6DATE:
09/20/2023
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Administrator, Ana Osborne and Caregiver, Melisande BauzonTIME COMPLETED:
04:25 PM
ALLEGATION(S):
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Staff did not provide resident's authorized representative with a refund
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced visit to initiate a complaint investigation regarding the above allegation. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Melisande Bauzon. Administrator Ana Osborne arrived during the visit and assisted the LPA.

Throughout the investigation, the Department secured pertinent records and conducted interviews with internal and external sources.

It was alleged the facility did not provide a resident's authorized representative with a refund. It was reported to the Department Resident #1 (R1) had moved into the facility on 8/16/23, passed away on 8/21/23, and R1’s belongings were removed from the facility on 8/26/23.
Review of R1’s admission agreement, along with interviews with internal and external sources, revealed a pre-admission fee of Fifteen hundred dollars ($1,500) and a monthly fee of Seven thousand dollars ($7,000).
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) -76-2351
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
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 08-AS-20230919120951
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: JOY & JAY HOME CARE
FACILITY NUMBER: 374601895
VISIT DATE: 09/20/2023
NARRATIVE
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 Interviews also corroborated the agreement indicated pre-admission fees were non-refundable, monthly fees were non-refundable upon a resident’s death, and that a refund was not provided to R1’s authorized representative.

Based on the evidence obtained, a refund was not provided as indicated in California Code of Regulations Title 22, nor in the Health and Safety Code.

The allegation was substantiated and cited in an LIC 9099D. A plan of correction was jointly formulated with Administrator Osborne.

An exit interview was conducted with Osborne, to whom a copy of this report, LIC 9099D, and Licensee/Appeals Rights (LIC 9058) were provided.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) -76-2351
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20230919120951
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: JOY & JAY HOME CARE
FACILITY NUMBER: 374601895
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/20/2023
Section Cited
HSC
1569.652(c)
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§1569.652 Termination of admission agreement upon death of resident; removal of resident’s property; refund of fees paid; notice of contract termination and refunds (c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed. This Requirement was not met as evidenced by:
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Administrator agree to refund R1's authorized representative $6,016.12, by 9/29/23. Administrator agreed to provided proof of refund by 9/29/23.
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Based on interviews and review of records, the licensee did not ensure a refund was provided to R1's authorized representative, which posed a potential health, safety and personal rights risk to 1 of 6 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: Lizzette TellezTELEPHONE: (619) -76-2351
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3