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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 435202744
Report Date: 09/17/2024
Date Signed: 09/17/2024 05:27:17 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
08/13/2024 and conducted by Evaluator Chihhsien Chang
COMPLAINT CONTROL NUMBER: 26-AS-20240813092234
FACILITY NAME:WESTMONT OF MILPITASFACILITY NUMBER:
435202744
ADMINISTRATOR:BECKER, GREGORYFACILITY TYPE:
740
ADDRESS:80 CEDAR WAYTELEPHONE:
(408) 770-9575
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:225CENSUS: 167DATE:
09/17/2024
UNANNOUNCEDTIME BEGAN:
03:17 PM
MET WITH:Greg BeckerTIME COMPLETED:
04:28 PM
ALLEGATION(S):
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Facility staff did not properly notify resident of rate increase.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Steve Chang conducted an unannounced investigation visit to deliver the investigation report, and met with Executive Director (ED) Greg Becker.

On 8/13/2024, the Department received a complaint that the facility increased the rate without notifying residents.

On 8/23/2024, LPA conducted an initial investigation visit. LPA interviewed ED, 1 staff, and 3 residents.

LPA requested document including a new 60 day notice of rate increase issued to R1, Assisted living care fee, R1's ledger of care level payment, and 1 copy of new 60 days notice of rate increase signed by R1.

Continue on LIC9099-C. Page 1 of 2..
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
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 26-AS-20240813092234
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: WESTMONT OF MILPITAS
FACILITY NUMBER: 435202744
VISIT DATE: 09/17/2024
NARRATIVE
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Facility staff did not properly notify resident of rate increase:
On 8/23/2024, LPA interviewed Executive Director (ED) Greg Becker. ED stated he/she starts to work for the facility at the end of January 2024. ED stated the previous management team issued a 60 day notice of rate increase to R1 in October 2023. ED stated the effective date of the rate increase is 1/1/2024. ED stated R1 claimed he/she did not receive the notice of rate increase and refused to pay. ED stated R1 still pays the old rate from 1/1/2024. ED stated the facility still provides the services without disruption. ED stated he/she cannot find the letter of rate increase sent to R1 in October 2023. ED stated the facility has made a decision to send R1 a new 60 day notice of rate increase and to take effective on 11/1/2024. ED stated the facility will waive the difference of the old rate and the new rate from January 2024 to October 2024.

LPA interviewed Business Office Director (BOD). BOD stated he/she starts to work for the facility at the end of February 2024. BOD stated R1 talked to him/her about this issue around 2 months ago. BOD stated he/she checked R1's account and found R1 did not pay the increased rate, but just paid the old rate. BOD stated he/she was unable to find the letter of rate increase sent to R1 in October 2023. BOD stated he/she will waive R1's payment difference from January 2024 to October 2024.

LPA interviewed resident R1. R1 stated he/she did not receive the notice of rate increase and he/she refused to pay the new rate. R1 stated he/she still receives the facility care and service without disruption. R1 stated he/she receives a 60 day notice of rate increase and the effective date of the new rate is 11/1/2024. R1 stated the facility will waive the difference between the old rate and the new rate from January 2024 to October 2024. R1 stated he/she agrees to pay the new rate starting 11/1/2024.

Based on the review of R1' account ledger and documents, R1 did not pay the new rate since 1/1/2024. Based on the interviews, R1 receives the facility care and service as usual. LPA observed a copy of a new 60 day notice of rate increase dated 8/23/2024 with R1's signature.

The Department has investigated the above allegation. Based on the investigation, records reviewed, and interviews, the Department found that the above allegations is UNFOUNDED, meaning that the allegation is false, could not have happened and/or is without a reasonable basis.
No citation noted today. Exit interview was conducted with ED. A copy of the report was provided to ED.

Page 2 of 2.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2