Complaint Investigation Report

011405838-2-27-2025-15-AS-KHOS-DEPPQR-20250312113134

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

08/23/2024 and conducted by Evaluator Grace Luk

COMPLAINT CONTROL NUMBER: 15-AS-20240823143906

Staff had inappropriate interaction with resident.

On 2/27/2025 at 3:50PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings regarding the allegation above. LPA met with Administrator, Tsion Haile (Mogesse) and informed her the reason for the visit.

During the course of investigation, LPA interviewed 2 clients, 3 staff, and complainant. LPA reviewed and obtained documents including SIRs, emergency information, IPP, ISP, Physician's report, and internal investigation reports. Interview with S1 indicated that S3 reported an incident where S4 had inappropriate interactions with a client. Interview with C1 revealed that nothing happened between her and S4. C1 stated she feels safe at the facility and no staff made her feel uncomfortable.

Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. No deficiencies are being cited on this date. Exit interview conducted. A copy of this report provided.