Complaint Investigation Report

011401330-11-2-2021-15-AS-HHUL-CEBUPB-20220511154512

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

10/25/2021 and conducted by Evaluator Grace Luk

COMPLAINT CONTROL NUMBER: 15-AS-20211025143344

On 11/2/2021 at 9:06AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation in regards to the allegations above. LPA met with Administrator, Claudia Acosta and informed her about the allegations.

During the course of investigation, LPA interviewed clients and staff. LPA toured the facility and observed the roof was leaking in two bedrooms. LPA also observed that the sliding glass door of the bathtub was broken where the glass swings out. Interviews with clients and staff indicated that the two bedrooms had water leakage when raining and the plastic part of the sliding glass door was broken.

Based on LPA's information obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegations is found to be SUBSTANTIATED. California Code of Regulations, Title 22, are being cited on the attached LIC 9099D. Exit interview conducted. A copy of this report and appeal rights provided.