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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 385601116
Report Date: 09/05/2024
Date Signed: 09/05/2024 11:38:21 AM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/09/2024 and conducted by Evaluator Jaime Vado
PUBLIC
COMPLAINT CONTROL NUMBER: 14-AS-20240709153531
FACILITY NAME:COTERIE CATHEDRAL HILLFACILITY NUMBER:
385601116
ADMINISTRATOR:LALOYAN,SIRUN SARAHFACILITY TYPE:
740
ADDRESS:1001 VAN NESS AVENUETELEPHONE:
(415) 915-6615
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY:260CENSUS: 165DATE:
09/05/2024
UNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:General Manager - Matt Turner TIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
- Staff did not do a proper assessment
- Staff are charging residents for services not rendered
- Staff are not following the admission agreement
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 09/05/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit to deliver findings regarding the received allegations. LPA met with general manager Matt Turner and LPA explained the purpose of today's visit.

During the investigation, LPA conducted interviews and reviewed pertinent documentation related to the complaint allegations. It was discovered that both residents R1 and R2 did sign admission agreements with the facility and had specific move in dates. Due to circumstances, such as a rate increases due to higher level of care being needed for both residents, both residents did not move in, and decided to submit their notices of moving out. Both residents never moved into the facility, but per the admission agreements signed is does indicate a 60 day notice to the facility if a resident decides to move out. The facility is upholding that 60 day notice rule and are charging the residents for those 60 days. Additionally regarding the admission agreement, the agreed upon rates at time of admission signing was in place until the facility discovered after signing that both residents needed additional services added to their care plans which increased the rate at time of signing. Assessments were done at the time of signing but new services were needing to be added and new physicain's reports and service plans were needed to address the additional changes. These allegations are unfounded.

This agency has investigated the complaint alleging, "Staff did not do a proper assessment, Staff are charging residents for services not rendered, and Staff are not following the admission agreement". We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Report is reviewed with Matt Turner and a copy is provided.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: April CowanTELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Jaime VadoTELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2024
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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