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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425850204
Report Date: 04/21/2025
Date Signed: 04/22/2025 08:40:55 AM

Substantiated


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
01/11/2024 and conducted by Evaluator Kristin Kontilis
COMPLAINT CONTROL NUMBER: 29-AS-20240111092634
FACILITY NAME:MISSION VILLAFACILITY NUMBER:
425850204
ADMINISTRATOR:NEWQUIST, DANAFACILITY TYPE:
740
ADDRESS:321 W MISSION STREETTELEPHONE:
(805) 898-2709
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY:15CENSUS: 12DATE:
04/21/2025
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Emily Gerr, AdministratorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility increased resident’s rate without proper notice.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kristin Kontilis conducted a subsequent complaint visit to issue final findings on this investigation. LPA met with Emily Gerr, Administrator and explained the purpose of the visit. During the investigation, LPA conducted an initial visit on 1/17/2024 from 10:00 am to 4:00 pm, where LPA interviewed staff and residents and requested documents; LPA also conducted additional interviews by phone with relevant parties including responsible parties and witnesses.
On the allegation: Facility increased resident’s rate without proper notice. It was alleged the administrator increased Resident 1's (R1’s) rent by $1,000 without proper notice. R1’s responsible party indicated when R1 moved in, they did not receive a copy of the admission agreement they signed despite asking for a copy for months. Per the verbal agreement when R1 moved in, R1’s total rent was $7,000, and incontinence supplies would be provided through hospice. After providing the initial $7,000, the licensee then asked for a “preadmission” fee of $3,000 that was not verbally disclosed initially, nor through writing since the responsible party had not received a copy of the admission agreement. Despite this, the responsible party paid the fee.
Please continue to 9099-C, Pg 2.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 29-AS-20240111092634
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: MISSION VILLA
FACILITY NUMBER: 425850204
VISIT DATE: 04/21/2025
NARRATIVE
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In December 2023, the licensee emailed R1’s responsible party to notify them the rent would be increased from $7,000 to $8,000 per month, due to a higher level of care needed. However, R1 had not had any increase in the higher level of care since moving into the facility, and no reappraisal was completed. R1’s responsible party also noted despite asking for a copy of the admission agreement for months, they had not received a copy. R1’s responsible party continued to pay $7,000 for the care, and the licensee attempted to have the responsible party sign a new admission agreement for $8,000. Administrator stated R1 increased from a Level 4 to Level 5 care plan, and believed the increase was valid. Credible witness interviewed confirmed R1 had no change in care needs since moving into the facility. Another responsible party confirmed they received an increase notice on March 22, with an effective date of May 15, which was not a full 60 days’ notice.
It was also alleged the licensee was charging R1 $350 per month for incontinence supplies, even though hospice was providing them. R1’s POA confirmed R1 was being charged $350 from the facility directly for incontinence supplies, even though the incontinence supplies were being provided through insurance and hospice. Responsible party stated administrator said they put the hospice incontinence supplies “in the supply closet as back up.” Interviews confirmed the briefs were all comingled in the supply closet, and staff used them for any resident. In addition, R1’s POA stated the administrator asked for the $350 to be paid in advance.
After R1’s responsible party discussed the issue with the licensee in January 2024, they agreed to remove the $350 charge. However, the licensee sent a letter on 1/2/2024 indicating there was a balance owed on R1’s account and they were serving an eviction notice due to nonpayment. R1’s responsible party refused to pay the additional cost. The administrator later sent a text stating they did not need to pay the $1,000. The fact remains R1 and their responsible party were not given proper notice of the rate increase. Based on the information obtained, the allegation is deemed Substantiated at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 9099-D):

Exit interview conducted. Copy of report and Appeal Rights issued at the time of the visit.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 29-AS-20240111092634
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: MISSION VILLA
FACILITY NUMBER: 425850204
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/25/2025
Section Cited
HSC
1569.657(a)
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1569.657(a) For any rate increase due to a change in the level of care of the resident, the licensee shall provide the resident and the resident’s representative…written notice of the rate increase within two business days after initially providing services at the new level of care. The notice shall include a detailed explanation of the additional services to be provided at the new level of care and an accompanying itemization of the charges.
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Licensee/Administrator agrees to submit a signed statement of understanding of 1569.657 and 87507, pertaining to admission agreements and rate increases.
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This requirement was not met as evidenced by: Based on interview and record review, the licensee did not comply with the section when they increased R1’s rate without justification, which posed a potential health, safety and personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
01/11/2024 and conducted by Evaluator Kristin Kontilis
COMPLAINT CONTROL NUMBER: 29-AS-20240111092634

FACILITY NAME:MISSION VILLAFACILITY NUMBER:
425850204
ADMINISTRATOR:NEWQUIST, DANAFACILITY TYPE:
740
ADDRESS:321 W MISSION STREETTELEPHONE:
(805) 898-2709
CITY:SANTA BARBARASTATE: CAZIP CODE:
93101
CAPACITY:15CENSUS: 12DATE:
04/21/2025
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Emily Gerr, AdministratorTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility is not following admission agreement.
Insufficient staffing to meet resident's needs.
Facility is not kept at a comfortable temperature for residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kristin Kontilis conducted a subsequent complaint visit to issue final findings on this investigation. LPA met with Emily Gerr, Administrator and explained the purpose of the visit. During the investigation, LPA conducted an initial visit on 1/17/2024 from 10:00 am to 4:00 pm, where LPA interviewed staff and residents and requested documents; LPA also conducted additional interviews by phone with relevant parties including responsible parties and witnesses.
On the allegation: Facility is not following admission agreement. It was alleged the administrator was requiring Resident 2 (R2) and Resident 3 (R3) to pay their rent early.
One responsible party interviewed confirmed the licensee Lisa Gerr and administrator Emily Gerr had sent numerous requests via email and text, asking that the rent be paid early and upfront for multiple months at one time. R2’s responsible party indicated they were not asked to pay the rent early. R3’s responsible party stated the licensee asked for payment three months in advance in exchange for a 10% discount, which they accepted. Although the allegation may have happened or is valid, there is not a preponderance of evidence
Please continue to 9099-C, Pg 2.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20240111092634
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: MISSION VILLA
FACILITY NUMBER: 425850204
VISIT DATE: 04/21/2025
NARRATIVE
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to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated at this time. The licensee is reminded of their responsibility to follow admission agreements.
On the allegation: Insufficient staffing to meet resident's needs. It was alleged that staff were not showing up to their shift due to the administrator not paying staff.
Interviews revealed multiple staff’s hours were cut and their days of work decreased. Additionally, when staff went to pick up their paycheck it was not available. It was also stated the licensee would hold the checks in their possession and tell staff they needed to do additional work to receive the check. Other times staff had to follow the licensee to the bank, and the licensee handed them cash. Interviews revealed staff sometimes worked double shifts to cover staffing, otherwise the administrator or their partner would come in to cover the shift. Interviews revealed more staff at night would be beneficial, but there was insufficient evidence to prove any residents’ needs were not met as a result. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated at this time. The licensee is reminded of their responsibility to ensure sufficient staffing at all times.
On the allegation: Facility is not kept at a comfortable temperature for residents. It was alleged residents at the facility complained of being cold. One resident’s visitor stated when they visit a resident, the resident complains about being cold. The visitor has requested numerous times that the heat be turned on. The visitor stated one resident’s hands were observed to be purple, and another resident woke up and stated it was always cold in there. Interviews revealed the bathrooms can be cold because they have no heating, so the hot water needs to be run for a while to warm up the bathroom. Some persons interviewed believe the common area can be cold for residents if the air conditioning is blowing directly on them, while others interviewed stated the temperature in the facility was comfortable. Administrator stated some residents are always cold, so they provide them blankets. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated at this time. The licensee is reminded of their responsibility to provide residents a comfortable temperature.

Exit interview conducted. Copy of report issued at the time of the visit.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5