Complaint Investigation Report

019200807-8-25-2023-15-AS-KHOS-CWGJ4H-20231010064310

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

09/09/2022 and conducted by Evaluator Grace Luk

COMPLAINT CONTROL NUMBER: 15-AS-20220909164658

On 8/25/2023 at 2:40PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings in regards to the allegation above. LPA met with Administrator, Shirley Marshall and informed her the reason for visit.

During the course of investigation, LPA interviewed 5 residents, 3 staff, and complainant. LPA also obtained and reviewed documents including physician's report, care plan, and emergency information. Interview with residents revealed that residents' hygiene needs are being met. R1 stated she handles her own ADL (Activities of Daily Living) care and does not need assistance with hygiene needs.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted. A copy of this report provided.