Complaint Investigation Report

019200654-2-23-2022-15-AS-KHOS-CCBMMG-20220308084356

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

06/04/2021 and conducted by Evaluator Leslie Ibo

COMPLAINT CONTROL NUMBER: 15-AS-20210604131506

On this day 2/23/2022, Licensing Program Analyst (LPA) Leslie Ibo arrived unannounced to deliver findings on the above allegations. LPA met with Christine Pagdatu, staff, Administrator is not available during the visit.

On 6/7/2021, LPA Luisa Fontanilla initiated 10-day investigation, interviewed Administrator, Client 1 (C1) and Staff 1 (S1), obtained and reviewed C1’s Individual Program Plan (IPP).

Based on interviews conducted, S1 who is the primary caregiver for C1 denied hurting C1. S1 states C1 is like a sibling and would never hurt C1 or any other client. When interviewed by LPA, C1 states C1 likes the staff at the home because they are fair. C1 denied getting hurt or threatened by any staff or witnessing any staff hurt a client.

Based on interviews conducted and records review, the above allegations are unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

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