435202895-12-5-2025-26-AS-RMAO-DQNVH2-20260125152624

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435202895
Report Date: 12/05/2025
Date Signed: 12/05/2025 05:09:18 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
08/07/2025 and conducted by Evaluator Chihhsien Chang

COMPLAINT CONTROL NUMBER: 26-AS-20250807165257

FACILITY NAME:	MORNINGSTAR ASSISTED LIVING OF WEST SAN JOSE		FACILITY NUMBER:	435202895
ADMINISTRATOR:	HALL, STEPHANIE		FACILITY TYPE:	740
ADDRESS:	1380 S DEANZA BLVD		TELEPHONE:	(669) 295-6500
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95129
CAPACITY:	149	CENSUS: 110	DATE:	12/05/2025
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Jolie Higgins		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility did not provide resident with transportation to medical appointment.
Facility did not adhere to Admission Agreement by charging resident for services not rendered

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced investigation visit and met with Executive Director (ED) Jolie Higgins to deliver the investigation finding.

On 08/07/2025, the Department received a complaint with the above 2 allegations.

On 08/14/2025, the Department conducted an investigation visit. LPA interviewed previous Executive Director (PED), and 2 staff.

LPA requested the admission agreement, transpiration service policy, physician report, and appraisal needs and service plan,

Continue on LIC9099-C. page 1 of 4.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

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 4

Control Number 26-AS-20250807165257

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: MORNINGSTAR ASSISTED LIVING OF WEST SAN JOSE	FACILITY NUMBER: 435202895
	VISIT DATE: 12/05/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Facility did not provide resident with transportation to medical appointment:
On 08/14/2025, LPA interviewed precious Executive Director (PED). PED stated the facility policy is that residents need to make reservations 72 hours in advance for the facility transportation service. PED stated there is no emergency room visit and no urgent care visit for the facility transportation vehicles.

PED stated if the facility has the available capacity space for the transportation even the resident does not make reservations 72 hours in advance, the facility still provides the transportation service. PED stated Otherwise the facility arranges other transportation opportunities. PED stated if the needs of transportation is for emergency room visit, the facility will call 911.

PED stated in July 2025, resident R1 requested for urgent care/emergency room transportation. PED stated the facility told R1 that the facility will call 911 but R1 refused. ED stated the facility offered the opportunity to call Uber for the transportation and the facility will pay for it but R1 refused.

LPA interviewed staff S1. S1 stated the facility policy is that residents need to make an appointment 72 hours in advance for transportation and the facility does not provide transportation for emergency room visit or urgent care visit

S1 stated on 07/21/2025, resident R1 told him/her that R1 wanted to go to emergency room due to foot pain. S1 stated he/she told R1 that the facility transportation does not provide the service for emergency room visit due to the liability issue but he/she can call 911 to have ambulance to send R1 to emergency room. S1 stated R1 refused S1 to call 911. S1 stated he/she told R1 that the facility can call Uber to send R1 to emergency room and the facility pays the fee and R1 refused the offer. R1 told S1 that he/she will call S1 later to let S1 know what is R1's decision. S1 stated he/she did not receive R1's callback regarding R1's decision. S1 showed the phone call log on his/her cell phone.

Based on the review of the facility transportation log, R1 had the facility transportation services on 07/06/2025, 07/07/2025, 07/10/2025, 07/16/2025, 07/20/2025, and 07/22/2025.

Based on the interview and record reviewed, the facility provided the transportation service to R1. R1 requested the facility to transport R1 to emergency room and refused the facility to call 911 to transport R1 to emergency room. Continue on LIC9099-C. Page 2 of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 26-AS-20250807165257

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: MORNINGSTAR ASSISTED LIVING OF WEST SAN JOSE	FACILITY NUMBER: 435202895
	VISIT DATE: 12/05/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Facility did not adhere to Admission Agreement by charging resident for services not rendered:

On 08/14/2025, LPA interviewed previous Executive Director (PED). PED stated resident R1 moved in the facility on 06/26/2025 and moved out on 07/31/2025, but the facility only charged R1 one month rent from 07/01/2025 to 07/31/2025.

PED stated based on admission agreement, if the resident moves out from the facility within one month the facility refunds 80% of the community fee which is equal to one month rent.

PED explained the community fee equals to the resident's one month rent. The facility refunds to residents 80%, 60%, 40% of the community fee if residents move out within one month, within two months, or within 3 months. PED explained the facility does not refund the community fee if residents move out from the facility after 3 months. PED explained the purpose of the community fee is to let residents make a serious consideration/decision before moving in the facility. PED stated if residents really dislike to live the facility within 3 months, the facility refund some portion of the community fee to residents. PED stated this is specified in R1's admission agreement page 9. PED stated R1 signed the agreement and initial on page 9 of the agreement. PED stated the corporate already processed the refund check for R1.

PED stated on 07/20/2025 to 7/22/2025, he/she talked to R1 regarding the refund of 80% of community fee when R1 asked about the procedures of moving out from the facility.

LPA interviewed staff S2. S2 stated the facility prepared the check with the 80% of R1's community fee. S2 stated he/she received R1's refund check on 8/11/2025 from the corporate. S2 stated he/she tried to contact R1 to pick up the check but was unable to talk to her. S2 stated R1 is the conservator of self.

LPA reviewed R1's billing statement dated 06/23/2025, the community fee equals to one month rent is specified and it shows R1's signature on the billing statement. LPA reviewed R1's Admission Agreement dated 05/23/2025, the community fee and refund policy of community fee is specified in the admission agreement.

Continue on LIC9099-C. Page 3 of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 26-AS-20250807165257

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: MORNINGSTAR ASSISTED LIVING OF WEST SAN JOSE	FACILITY NUMBER: 435202895
	VISIT DATE: 12/05/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on the review of the copy of the cashed check, resident picked up the check on 09/08/2025 with R1's signature, and the check with the amount of $7,768.00 was cashed on 09/09/2025.

The Department has investigated the above allegations. Based on the investigation, records reviewed, and interviews conducted, the Department found that the above allegation is UNFOUNDED, meaning that the allegation is false, could not have happened and/or is without a reasonable basis.

No citations noted at today’s visit. Exit interview conducted with ED. This report was provided to review and for signature. A copy of this report was provided to ED.

Page 4 of 4.

SUPERVISORS NAME: Romeo Manzano
LICENSING EVALUATOR NAME: Chihhsien Chang
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025

LIC9099 (FAS) - (06/04)

Page: 4 of 4