405850034-9-26-2024-29-AS-KBUY-D9LRXL-20240930132455

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 09/26/2024
Date Signed: 09/26/2024 09:03:36 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/10/2024 and conducted by Evaluator Mark Jeffries

COMPLAINT CONTROL NUMBER: 29-AS-20240910130514

FACILITY NAME:	AVILA SENIOR LIVING AT DOWNTOWN SLO		FACILITY NUMBER:	405850034
ADMINISTRATOR:	DARLENE MARKHAM		FACILITY TYPE:	740
ADDRESS:	475 MARSH ST		TELEPHONE:	(805) 541-4222
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	100	CENSUS: 43	DATE:	09/26/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Administrator, Darlene Markham		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Facility is incorrectly charging a SSI resident for basic rate services.
Facility staff harrass resident in care.

INVESTIGATION FINDINGS:

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At 9:00am on 09/26/2024, Licensing Program Analyst (LPA) Jeffries conducted a subsequent complaint visit to issue final findings. During today’s visit, LPA met with Administrator, Darlene Markham and explained the reason for the visit. LPA Jeffries started the investigation by conducting staff interviews and requesting relevant documents. LPM Burley conducted additional interviews via phone on 9/24/2024.

On the allegation: Facility is incorrectly charging a SSI resident for basic rate services. It was alleged that the facility billed Resident 1 (R1) for laundry services even though they were an SSI resident. LPA reviewed documents for R1 including billing statements for March 2024 through September 2024. The document showed R1 was charged for laundry services on their bill each month, but also received credits for the laundry service for each month.

CONTINUED on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Mark Jeffries	TELEPHONE: (805)562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

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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Control Number 29-AS-20240910130514

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: AVILA SENIOR LIVING AT DOWNTOWN SLO	FACILITY NUMBER: 405850034
	VISIT DATE: 09/26/2024

NARRATIVE

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The statement, provided 9/17/2024, reflects laundry charges and credits on the following days: 3/8/2024, 4/1/2024, 5/1/2024, 6/1/2024, 7/1/2024, 8/1/2024, 9/1/2024. The statement does not show that R1 paid for laundry service.

Interview with Administrator revealed they are aware R1 is an SSI resident and cannot be charged for any additional care or services beyond SSI. Administrator stated due to a recent change, residents who wanted laundry service signed up for the service with the Business Office Manager. After the billing issue was brought up, Administrator checked into the issue and found R1 had signed up for laundry service through the Business Office Manager, so the charge was added to R1’s account. Administrator credited all the charges once the issue was discovered, and confirmed the charges have been removed from the October 2024 statement and there will be no laundry charges for R1 going forward. Administrator confirmed R1 did not contact them about the laundry fee prior to signing up, to check whether they needed to sign up or not. Interview with R1 confirmed R1 signed up for the laundry service, as they did want to receive assistance with their laundry. Based on the information obtained, the allegation is deemed Unsubstantiated at this time.

On the allegation: Facility staff harass resident in care. It was alleged that the facility ‘appears’ to be harassing R1 due to R1 receiving a laundry bill when they are an SSI resident. The investigation into this issue revealed a misunderstanding when R1 signed up directly for laundry services despite being an SSI resident where all services were already included, which led to the charge being added to R1’s account. R1 confirmed via interview they did not feel they were harassed about the laundry charge. Based on the information obtained, the allegation is deemed Unsubstantiated at this time.

Exit interview, report given.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Mark Jeffries	TELEPHONE: (805)562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024

LIC9099 (FAS) - (06/04)

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