374604533-12-6-2022-08-AS-LTEZ-CM4VB4-20221214151651

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604533
Report Date: 12/06/2022
Date Signed: 12/06/2022 01:10:50 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
09/09/2022 and conducted by Evaluator Nacole Patterson

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20220909150305

FACILITY NAME:	SANTIANNA OAKMONT SIGNATURE LIVING		FACILITY NUMBER:	374604533
ADMINISTRATOR:	THARP, CHRISTOPHER		FACILITY TYPE:	740
ADDRESS:	2560 FARADAY AVE		TELEPHONE:	(442) 325-8090
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92010
CAPACITY:	226	CENSUS: 134	DATE:	12/06/2022
		UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Sam El-Rabaa, Executive Director		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Licensee did not issue refund, as required.

INVESTIGATION FINDINGS:

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Interim Assistant Program Administrator (IAPA) Icela Estrada, and Licensing Program Analyst (LPA) Nacole Patterson conducted an unannounced complaint visit to the facility in order to deliver findings for the above allegation. IAPA and LPA introduced themselves, and disclosed the purpose of the visit to the Executive Director Sam El-Rabaa.

On September 9th, 2022, it was alleged that the facility did not issue a refund, as required, by not providing a refund of pre-admission fees upon withdrawal of the resident application. The Department’s investigation consisted of review of facility and outside source records and interviews of facility staff and outside sources.
During the month of July 2022, a Prospective Client (PC) met and signed a pre-admission agreement with facility staff (FS1) to be a prospective resident. PC completed the form and paid the required pre-admission Fee of $6,000 via check.

(Continue...)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20220909150305

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SANTIANNA OAKMONT SIGNATURE LIVING	FACILITY NUMBER: 374604533
	VISIT DATE: 12/06/2022

NARRATIVE

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On August 5th 2022, PC notified facility staff (FS2) via phone call and email confirmation that they would like to withdraw their application as they had decided not to be a resident of Santianna Oakmont Signature Living. PC requested a refund of their $6000 deposit.

Records reviewed from the facility confirm that PC provided written notice to withdraw the application on August 5th 2022.

PC emailed FS1 on August 18th 2022 and then sent FS1 a text message on August 20th 2022, as they had not received a response from FS2 after several contact attempts regarding verification that the refund is being processed. FS1 informed PC that they no longer work for the facility and referred them back to FS2 or facility staff (FS3) for the refund resolution.

On August 22nd 2022 PC emailed FS2 requesting an update on the refund status. FS2 replied to the inquiry and included FS3 in the exchange to confirm the status of refund. On 8/23/22 FS3 confirmed that the refund request had been submitted and was in processing, stating it could take up to 30 days from when notice is received requesting the refund and that checks are first received at the facility and then mailed out.

The facility's Deposit Agreement for Assisted Living & Memory Care states in section 5:
"Termination of Agreement by You. You may terminate this Agreement at any time by giving written notice to Oakmont at 2560 Faraday Avenue, Carlsbad, CA 92010. Upon cancellation of this agreement by you, you will receive a full refund of the deposit within thirty (30) calendar days."

Administrator confirmed during interview that the time frame for refund of pre-admission fees is 30 days. Evidence provided by the facility shows that a refund check of $6000 was made out to PC on September 8th 2022, which is greater than 30 calendar days from written notice that was given on August 5th, 2022.

Based on the evidence obtained during the complaint investigation, the allegation that the Licensee did not issue refund, as required, is found to be SUBSTANTIATED, as there is a preponderance of evidence to show that the violation occurred. Pursuant to the California Code of Regulations, Title 22, Division 6, a deficiency was cited on the attached LIC9099D, and a plan of correction was jointly developed with Executive Director Sam El-Rabaa.

An exit interview was conducted with Executive Director Sam El-Rabaa, to whom a copy of this report, Licensee's Rights (LIC9058), LIC9099-C, and LIC9099-D were provided.

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20220909150305

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SANTIANNA OAKMONT SIGNATURE LIVING	FACILITY NUMBER: 374604533
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/06/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/06/2022 Section Cited CCR 87507(g)5(E)(1)	1 2 3 4 5 6 7	Preadmission fees shall be refunded according to the following conditions: 1. A 100 percent refund of a preadmission fee shall be provided to an applicant or the applicant’s representative if: a. The applicant decides not to enter the facility prior to the facility completing a preadmission appraisal as defined in Section 87457.	1 2 3 4 5 6 7	Executive Director has implemented a process where the staff in charge of processing refunds will monitor the timeline closely to ensure they refund is issued within 30 days.
	8 9 10 11 12 13 14	Based on interviews and record review, the licensee did not provide the pre-admission refund in 1 of 134 persons in care [PC] which posed a potential Personal Rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Tellez	TELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole Patterson	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

LIC9099 (FAS) - (06/04)

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