Complaint Investigation Report

019201373-6-24-2025-15-AS-KHOS-DJMKEW-20250716075101

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

06/18/2025 and conducted by Evaluator James Sampair

COMPLAINT CONTROL NUMBER: 15-AS-20250618082702

Staff are not providing adequate food service to resident(s)

On 6/24/2025, at 11:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to investigate the allegation above. Upon arrival, the LPA informed Executive Director (ED) Jeff Sumabat of the purpose of the visit.

The complaint alleges staff are not providing adequate food service to resident(s).

The LPA interviewed Witness W1 by telephone. At the facility, the LPA interviewed the ED and nine residents. The data collected from the interviews shows that the staff are providing adequate food service to residents of the facility, which does not confirm the allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided.