445294156-10-23-2025-26-AS-RMAO-DNJKL9-20251118065933

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 445294156
Report Date: 08/01/2025
Date Signed: 10/23/2025 10:25:45 AM

Unfounded

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
07/24/2025 and conducted by Evaluator Marcella Tarin

COMPLAINT CONTROL NUMBER: 26-AS-20250724093244

FACILITY NAME:	BROOKDALE SCOTTS VALLEY		FACILITY NUMBER:	445294156
ADMINISTRATOR:	KUMAR, BEENA		FACILITY TYPE:	740
ADDRESS:	100 LOCKEWOOD LN		TELEPHONE:	(831) 438-7533
CITY:	SCOTTS VALLEY	STATE: CA	ZIP CODE:	95066
CAPACITY:	220	CENSUS: 171	DATE:	08/01/2025
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Executive Director, Alex Baiasu		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff do not permit residents' to choose their pharmacy
Staff did not notify resident's responsible party of fee increase

INVESTIGATION FINDINGS:

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This is an amended report 10/23/2025 to change the findings from unsubstantiated to unfounded.
Licensing Program Analyst (LPA) Marcella Tarin arrived unannounced to conduct the initial complaint investigation visit. LPA met with Executive Director (ED) Alex Baiasu. LPA stated the purpose of the visit.

On 7/24/2025 the Department received a complaint with the above allegations.

During the visit, LPA interviewed 1 Staff and ED.

On 7/30/2025 LPA interviewed Witness 1 (W1). W1 stated the facility did not allow R1 to choose his/her own pharmacy, and was not notified of the fee increases for the pharmacy.

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Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2025

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 26-AS-20250724093244

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: BROOKDALE SCOTTS VALLEY	FACILITY NUMBER: 445294156
	VISIT DATE: 08/01/2025

NARRATIVE

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This is an amended report 10/23/2025 to change the findings from unsubstantiated to unfounded.
W1 stated he/she had a meeting on 7/28/2025 and came to a 'mutual agreement' regarding the choice of pharmacy and fees for Resident R1. W1 stated the facility refunded the pharmacy fees charged to R1. W1 stated he/she agreed with the terms of pharmacy and was 'satisfied.' W1 stated R1 received the letter regarding the pharmacy but did not understand the pharmacy change.

LPA interviewed ED. ED states all residents were informed of the preferred pharmacy and fees by letter on 5/27/2025. ED states residents still have the option to choose their own pharmacy. ED stated the facility had a meeting with W1 on 7/28/2025 regarding the choice of pharmacy and fees for R1. ED stated the facility explained to W1 the terms of the preferred pharmacy for R1. ED stated W1 agreed with the terms for the preferred pharmacy for R1.

LPA interviewed Staff S1. S1 states he/she was part of the meeting with W1 and ED on 7/28/2025. S1 stated he/she explained how the preferred pharmacy would work for R1. S1 stated W1 agreed to the terms of the preferred pharmacy.

LPA reviewed R1's Resident Pharmacy Enrollment Form dated and signed by W1 on 7/28/2025. LPA reviewed a letter from the facility dated 5/27/2025, informing residents about the facility preferred pharmacy and fees. The letter states " For residents who do not choose to utilize the preferred pharmacy, charges will begin on...July 2025. Please note that residents were notified of this charge either upon moving in or their annual rate adjustment letters sent earlier this year."

This agency has investigated the complaint alleging staff do not permit residents' to choose their pharmacy, and staff did not notify resident's responsible party of fee increase. 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. An exit interview was conducted, and a copy of this report was provided.

No deficiencies were cited during today’s visit based on California Code of Regulations (CCR) Title 22. An exit interview was conducted with Executive Director (ED) Alex Baiasu. A signed copy of this report was provided.
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End of Report.

SUPERVISORS NAME: Jin Jackie
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2025

LIC9099 (FAS) - (06/04)

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