Complaint Investigation Report

015601374-2-23-2022-15-AS-KHOS-CKBPJP-20221018112152

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

02/17/2022 and conducted by Evaluator Leslie Ibo

COMPLAINT CONTROL NUMBER: 15-AS-20220217144949

Paul Shepodd, Administrator & Sashi Madahar- health and services director

Facility staff are not adequately trained.

On 02/23/2022 at 3:00PM Licensing Program Analyst (LPA) L. Ibo arrived unannounced to in order to meet the 10-day requirement for notification of the above allegation. LPA met with Paul Shepodd, new Administrator and Shashi Madahar, health services director of the facility, LPA explained the purpose of the visit.

LPA conducted interview, based on the interview with the staff, facility had incident where night shift staff does not know where the medication key was kept, S2 admitted that staff was newly hired and not trained.

Based on LPA information obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegation are found to be SUBSTANTIATED. California Code of Regulations, Title 22, are being cited on the attached LIC9099D.

Exit interview conducted. A copy of this report and appeal rights provided.