Complaint Investigation Report

015600255-6-19-2024-15-AS-KHOS-D6KJKZ-20240625070757

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

06/17/2024 and conducted by Evaluator Gregory Clark

COMPLAINT CONTROL NUMBER: 15-AS-20240617122846

Staff did not meet a resident's oxygen needs

Staff mishandled a resident's personal belonging

On 6/19/24 at 2:20 p.m., Licensing Program Analysts (LPAs) Greg Clark and A. Gharachorloo arrived unannounced to conduct an initial 10-day complaint investigation and deliver findings in regard to the allegations above. LPA met with Josephine Davis, Administrator and explained the purpose of the visit.

LPAs interviewed S1 who stated R1 lives in the Mercy Retirement & Care Center’s Skilled Nursing Facility(SNF). He does not live in the building licensed by CCL. LPAs reviewed resident rosters of both facilities and found R1 on the roster for the SNF.

This agency has investigated this complaint. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Exit interview conducted, a copy of this report provided.