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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202806
Report Date: 09/25/2025
Date Signed: 09/25/2025 04:51:33 PM

Substantiated


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
07/10/2025 and conducted by Evaluator Christine Kabariti
COMPLAINT CONTROL NUMBER: 26-AS-20250710154104
FACILITY NAME:MERRILL GARDENS AT GILROYFACILITY NUMBER:
435202806
ADMINISTRATOR:BILLY MITCHELLFACILITY TYPE:
740
ADDRESS:7610 ISABELLA WAYTELEPHONE:
(206) 676-5300
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY:214CENSUS: 136DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:General Manager, Billy MitchellTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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The licensee did not comply with the resident’s admission agreement resulting in the resident being charged excess fees
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christine Kabariti arrived unannounced to deliver the finding for the above allegation. LPA met with Executive Director, Billy Mitchell.

On 07/10/2025, the Department received the complaint alleging that the licensee did not comply with resident (R1)’s admission agreement resulting in R1 being charged excess fees. On 07/17/2025, the initial complaint investigation was conducted.

Documents were obtained to include resident roster, resident (R1)'s admission agreement, ledger, progress notes, and correspondence.

Page 1 of 2.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
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 3
Control Number 26-AS-20250710154104
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: MERRILL GARDENS AT GILROY
FACILITY NUMBER: 435202806
VISIT DATE: 09/25/2025
NARRATIVE
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Based on the reporting party (RP), it was reported that R1 moved into the facility in October 2024 and in late November 2024, R1 required hospitalization following almost 3 months at a rehab center (November 2024– February 2025). While R1 was in rehab, R1 was charged for assisted living care services in December 2024, after being told by the facility staff that R1 would only be charged monthly rent for the apartment.

Based on the facility’s admission agreement with R1, it’s stated under the apartment hold policy that “When you have been away from your Apartment for 14 consecutive days, credit for Assisted Living Services will be given beginning on day 15 until you return”.

On 07/17/2025, the General Manager was interviewed who stated that the Business Office Director (BOD) who was handling the R1’s credit no longer works for the community and did not leave any communication regarding R1’s billing. It was stated that the BOD already had prior approval back in December 2024 to credit the amount back to the resident’s account but the GM was unsure why the BOD did not complete the refund.

The GM admitted that the credit was not completed in December 2024.

On 07/17/2025, the GM and VP of Operations processed the credit back to R1’s account. Proof of the ledger showing the credit was provided to the Department.

The Department has investigated the above allegation. Based on interview, record review and observation the above allegation the preponderance of evidence standard has been met, therefore, the above allegation is substantiated. A deficiency was cited per California Code of Regulations, Title 22. See LIC9099-D. This report was reviewed with General Manager, Billy Mitchell and a copy of the report was provided.

Page 2 of 2.
SUPERVISORS NAME: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 26-AS-20250710154104
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: MERRILL GARDENS AT GILROY
FACILITY NUMBER: 435202806
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/02/2025
Section Cited
CCR
87507(f)
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(f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement is not met as evidenced by:
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On 07/17/2025, the GM and VP of Operations credited back R1’s assisted living care services costs and submitted the ledger to LPA Kabariti showing the care cost was credited back. Deficiency cleared during visit.
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Based on interview, record review and observation the licensee did not comply with the section cited above wherein the licensee did not comply with the terms and conditions set forth in resident (R1)’s admission agreement by not ensuring R1 was credited assisted living care services costs per the admission agreement timeframe which poses a potential health, safety, and personal rights risk to persons 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: Jackie Jin
LICENSING EVALUATOR NAME: Christine Kabariti
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
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