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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 445294156
Report Date: 02/06/2026
Date Signed: 02/06/2026 03:15:33 PM

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
06/02/2025 and conducted by Evaluator Marcella Tarin
COMPLAINT CONTROL NUMBER: 26-AS-20250602141402
FACILITY NAME:BROOKDALE SCOTTS VALLEYFACILITY NUMBER:
445294156
ADMINISTRATOR:KUMAR, BEENAFACILITY TYPE:
740
ADDRESS:100 LOCKEWOOD LNTELEPHONE:
(831) 438-7533
CITY:SCOTTS VALLEYSTATE: CAZIP CODE:
95066
CAPACITY:220CENSUS: 157DATE:
02/06/2026
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Executive Director Alex BaiasuTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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 Facility is charging resident for services not rendered.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced complaint investigation visit to deliver the finding on the above allegation. LPA met with Executive Director (ED) Alex Baisu.

On 6/2/2025 the Department received a complaint with the above allegation.

On 6/4/2025 the Department conducted a complaint investigation visit and interviewed 1 Staff and 3 Residents. Staff S1 states residents.

On 6/3/2025 and 2/5/2026 the Department requested information from the Reporting Party (RP). On 2/6/2026 the Department interviewed RP. RP states the issue has been resolved and the charges were not related to services at the facility.

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Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026
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-20250602141402
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: 02/06/2026
NARRATIVE
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RP states R1 was not evicted from the facility in March 2025. RP states R1 owed fees to the facility in March 2025.

Review of R1’s invoice dated 3/12/2025 notes invoices from 5/2024 to 10/16/2024 for ‘Monthly Invoices’ for $403. Review of R1’s Account History Report from 1/14/2022 to 5/30/2025 does not note R1 "Monthly invoices" in the amount of $403.

Review of R1’s Account History Report from 1/14/2022 to 5/30/2025 does not show any charges for oxygen concentrators or transportation services. R1’s Account History Report notes R1 owes facility fees related to late payments and not paying his/her balance in full as of 5/30/2025.

On 2/6/2026 the Department interviewed S1. S1 states R1 was not evicted in March 2025 and R1 currently resides at the facility. S1 states the facility continues to work with R1 in getting him/her to paying his/her balance.

Review of R1’s Admission Agreement notes R1 moved into the facility on 12/31/2021.

This agency has investigated the complaint alleging Facility is charging residents for services not rendered. 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 with Executive Director (ED) Alex Baiasu and a copy of this report was provided.

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026
LIC9099 (FAS) - (06/04)
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