Complaint Investigation Report
019200735-1-26-2023-15-AS-KHOS-CP3NSN-20230215094324
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CCLD Regional Office , 1515 CLAY STREET, STE. 310
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/12/2022 and conducted by Evaluator Kelly Nguyen
COMPLAINT CONTROL NUMBER: 15-AS-20220912135604
Resident sustained injuries while in care.
Facility did not seek medical attention for resident.
Facility is not adequately staffed to meet the needs of the resident's.
On 1/26/2023 at 11:40AM Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to deliver complaint finding for the above allegations. LPA met with Administrator, Joseph Gapasin and explained the purpose of the visit.
During the complaint investigation, LPA toured 4 resident's bedrooms, interviewed 2 staff, and attempted to interview 4 residents. Based on information obtained, R1 is self-inflicted and staff took preventative action to prevent R1 from sustaining future injuries. Staff seek medical attention on a timely matter. Facility have adequate staff after LPA reviewed staff payroll that correspond to staff’s schedule.
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 conducted and a copy of this report provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction