374604584-1-26-2023-08-AS-JRAE-CNM3YD-20230131173945

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604584
Report Date: 01/26/2023
Date Signed: 01/26/2023 11:11:47 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/15/2022 and conducted by Evaluator Ramon Serrano

COMPLAINT CONTROL NUMBER: 08-AS-20221215141518

FACILITY NAME:	MY NEW HOME - LODI GARDENS		FACILITY NUMBER:	374604584
ADMINISTRATOR:	MALMBERG, PONTIUS		FACILITY TYPE:	740
ADDRESS:	5289 LODI ST		TELEPHONE:	(858) 272-5286
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92117
CAPACITY:	6	CENSUS: 6	DATE:	01/26/2023
		UNANNOUNCED	TIME BEGAN:	10:02 AM
MET WITH:	Diep Malmberg		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Licensee did not adhere to the terms and conditions of the Admission Agreement.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced complaint visit to deliver findings on the above allegation. LPA met with Licensee Diep Malmberg and we discussed the purpose of the visit and elements of the complaint.

Community Care Licensing (CCL) has investigated the above allegation. The investigation consisted of records review and interview with facility staff.

In response to the allegation, it was alleged that resident's rent would be increasing, despite the residents' admission agreement stating that their would be no rent increases for the remainder of the resident's life.(R1) [an LIC 811 Confidential Names List was provided to the facility representative to identify the resident.] Review of records revealed a change of facility ownership that took place on July 5, 2022. Review of admission agreement from previous owner revealed a note indicating "no increase of rate up to end of life." As of December 19, 2022 a new admission agreement was not presented to the residents of previous facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

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-20221215141518

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: MY NEW HOME - LODI GARDENS	FACILITY NUMBER: 374604584
	VISIT DATE: 01/26/2023

NARRATIVE

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Interview with licensee revealed that on December 2022 a notice was sent out to all of the residents indicating an increase of rent would take effect in February 2023. Licensee further stated that they did not buy the former facility's admission agreements or any liability they had. The licensee only took over the lease in order to do business at the current location. The licensee further stated the cost of business right now is very high since everything's price has increased 30%-40% and they currently pay double the salary that the previous facility paid their staff.

Based upon the foregoing, the above listed allegation is unsubstantiated. This finding means that the preponderance of the evidence standard has not been met and the allegation is invalid.

An exit interview was conducted with Diep Malmberg and a copy of this report and Licensee/Appeal Rights (LIC9058, 3/22) were provided to Diep Malmberg whose signature below confirms receipt of documents.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Ramon Serrano	TELEPHONE: (619) 458-2583
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023

LIC9099 (FAS) - (06/04)

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