Complaint Investigation Report

019200513-2-15-2023-15-AS-KHOS-CPAVCX-20230222151951

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

01/30/2023 and conducted by Evaluator Gregory Clark

COMPLAINT CONTROL NUMBER: 15-AS-20230130110824

Staff have not repaired a washing machine for the residents

On 2/15/23 at 3:00 p.m., Licensing Program Analyst (LPA) G. Clark conducted an unannounced visit to deliver the findings for the above allegation. LPA met with Anthony Garcia, Administrator and explained the purpose of the visit.

During the course of investigation, LPA interviewed the complainant (RP) and the facility's administrator (ADM). LPA toured the independent living side of the facility and observed 1 washing machine (GE manufacturer) with an out of order sign taped to it. ADM was not able to produce records of repairs attempts for the washing machine.

Based on LPA’s observations and interviews conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8) and are being cited on the attached LIC 9099D.

Exit interview conducted, a copy of this report and appeal rights provided.