435200930-11-3-2023-26-AS-KHOS-DAAMQ4-20241022094808

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435200930
Report Date: 11/03/2023
Date Signed: 11/03/2023 04:38:08 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2023 and conducted by Evaluator David Marrufo

COMPLAINT CONTROL NUMBER: 26-AS-20231027131157

FACILITY NAME:	VI AT PALO ALTO		FACILITY NUMBER:	435200930
ADMINISTRATOR:	STEVE A. BRUDNICK		FACILITY TYPE:	741
ADDRESS:	620 SAND HILL ROAD		TELEPHONE:	(650) 853-5000
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94304
CAPACITY:	876	CENSUS: 526	DATE:	11/03/2023
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Robinetta Wheeler		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Facility staff financially abused resident while in care
Facility staff stole resident’s personal belongings

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced complaint investigation visit and met with Robinetta Wheeler, Director of Resident Services. On 10/27/2023, the Department received a complaint with the above allegations.

During visit, LPA Marrufo conducted interviews with resident R1, R1's family member, and staff S1-S6. During interview, R1 stated that staff S1-S3 have stolen items from R1's apartment, including food, clothing, jewelry, photo albums, and a bag of quarters. R1 also stated S3 stole R1's credit card.

During interview, R1's family member stated that the credit card actually belonged to R1's former spouse, who stated that there were two fraudulent charges the former spouse believed may have resulted from booking a flight with a travel agency. R1's family member stated that family members have come to R1's apartment to package items into boxes and move furniture around to better accomodate R1 after a surgery.

See LIC9099-C for more information. Page 1 of 2.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023

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 2

Control Number 26-AS-20231027131157

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: VI AT PALO ALTO	FACILITY NUMBER: 435200930
	VISIT DATE: 11/03/2023

NARRATIVE

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During interview, staff S1-S3 denied stealing any belongings from R1's apartment, including any credit cards.

Staff S4 and S5 stated to have conducted investigations to determine if anything had been stolen from R1's apartment. S4 and S5 stated that after R1 reported a bag of quarters were stolen, S4 and S5 found a bag of quarters in R1's apartment. However, R1 told S4 and S5 that it was a different bag of quarters that went missing. S4 and S5 also stated to have investigated another claim that R1 made about bottles of shampoo that were missing and when S4 and S5 found bottles of shampoo that matched R1's description of the missing shampoo bottles, R1 stated that it was another set of shampoo bottles that had gone missing.

Staff S6 stated during interview that R1 reported a manilla envelope was stolen from R1's apartment and when S6 came to R1's apartment to investigate, S6 observed the manilla envelope in R1's apartment. S6 let R1 know that the manilla envelope was in R1's apartment.

Based on information from interviews conducted with staff, resident, witnesses, and observations, although the allegations listed above may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are unsubstantiated.

No Deficiencies were cited under California Code of Regulations Title 22.

This report was reviewed with Robinetta Wheeler and a copy of this report was provided.

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2