374604722-10-31-2023-08-AS-SJAB-CX5V6U-20231031161007

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604722
Report Date: 10/18/2023
Date Signed: 10/31/2023 02:29:59 PM

Unsubstantiated

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
10/11/2023 and conducted by Evaluator Sabel Martinez

COMPLAINT CONTROL NUMBER: 08-AS-20231011114740

FACILITY NAME:	NOVELLUS CLAIREMONT LLC		FACILITY NUMBER:	374604722
ADMINISTRATOR:	LAIRD, CANDI		FACILITY TYPE:	740
ADDRESS:	5219 CLAIREMONT MESA BLVD.		TELEPHONE:	(858) 292-8044
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92117
CAPACITY:	214	CENSUS: 78	DATE:	10/18/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Executive Director Candi Laird		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Facility charged a resident for services not received

INVESTIGATION FINDINGS:

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*This is an amended report to a report originally signed on 10/18/2023.
Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced visit to initiate a complaint investigation. The LPA introduced himself and disclosed the purpose of the visit to Executive Director Candi Laird.
Throughout the investigation, the Department secured pertinent records and conducted interviews.
It was alleged the facility charged a resident for services not received. A review of the facility file revealed the facility was licensed on 10/01/23. Review of records obtained at the facility, confirmed the previous facility dated their invoices on 9/14/23, for monthly fees collected 10/01/23, for the month of October. Interviews with residents and staff corroborated the invoices were from the previous facility, and not from the current licensed facility. Invoices for the month of November 2023 have not been sent out to the residents as of today’s date.
Based on the evidenced collected throughout the investigation, the alleged violation was unsubstantiated.
An exit interview was conducted with Laird, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lizzette Tellez	TELEPHONE: (619) -76-2351
LICENSING EVALUATOR NAME: Sabel Martinez	TELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023

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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