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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603331
Report Date: 12/12/2024
Date Signed: 12/12/2024 02:11:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/09/2024 and conducted by Evaluator Tena Herrera
COMPLAINT CONTROL NUMBER: 28-AS-20241209121049
FACILITY NAME:BRIGHT STAR ASSISTED LIVINGFACILITY NUMBER:
198603331
ADMINISTRATOR:MARQUEZ, JOSE MFACILITY TYPE:
740
ADDRESS:9349 ROSE STREETTELEPHONE:
(818) 642-3668
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:70CENSUS: 57DATE:
12/12/2024
UNANNOUNCEDTIME BEGAN:
01:19 PM
MET WITH:Jennifer Serrano - Acting AdministratorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not give resident a proper rate increase.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced complaint visit to determine the validity of the above-mentioned allegation. LPA met with Jennifer Serrano and Silvia Vidal, and explained the reason for the visit.

The investigation consisted of the following:
LPA obtained copies of the staff and resident rosters, Notice of Payment Standard for Individuals from Social Security, LPA reviewed 3 resident admission agreements and rates. LPA interviewed 2 Staff (S1&S2) and 6 Residents (R1-R6).

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
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 28-AS-20241209121049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: BRIGHT STAR ASSISTED LIVING
FACILITY NUMBER: 198603331
VISIT DATE: 12/12/2024
NARRATIVE
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The Investigation Revealed the Following:
Allegation: Staff did not give resident a proper rate increase.
It is alleged that on 12/6/24 R1 was informed that they will have a rent increase of $400 and if they refused to pay the increase they would be evicted. LPA interviewed S1 and S2 and it was explained that the rent notification that was provided to residents was the new Social Security Payment Standard Increase that takes effect January 2025. This increase letter explains the new rate increase/adjustments to Social Security Income (SSI) benefits, the amount provided by SSI for room and board, and care and supervision has increased therefore the facility will now be receiving that new among. This came as a shock to residents as some residents were not used to paying their full amount that is on their agreement because the previous Administrator of the facility was not following protocol. Both S1 and S2 confirmed that the residents will not be charged back pay for the previous months but moving forward beginning in January 2025 residents will be responsible to pay the agreed amount. LPA reviewed R1’s admission agreement and the admission agreement indicated that the previous amount was for the previous year (2024) SSI amount for board and care. LPA also reviewed letter of increase that was given to R1 and it was the same as the Social Security Payment Standard Increase that was mentioned to LPA by Staff, LPA explained to R1 how this rate is done yearly and the facility themselves are adjusting the rent to match what Social Security is now providing for board and care costs. LPA interviewed 6 residents and 6 out of 6 residents indicated that they were provided with the rent increase letter in a timely manner, had no complaints and are used to the yearly minor adjustments to the rent.

Based on statements and interviews conducted, review of client files and increase letters, there was not enough supportive evidence to concur with the reported allegation. 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.

Exit interview held, and a copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2