Complaint Investigation Report

019200311-12-2-2021-15-AS-KHOS-CEGLZ3-20220516091116

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

01/04/2021 and conducted by Evaluator Gregory Clark

COMPLAINT CONTROL NUMBER: 15-AS-20210104090151

THOMAS-ADAMS RESIDENTIAL CARE FACILITY, INC.

Facility staff did not assist resident with making a medical appointment

On 12/2/2021 at 1:45 PM Licensing Program Analysts (LPAs) G. Clark and L. Francisco arrived unannounced to deliver findings for the above allegations. LPAs met with Licensee Matthew Thomas and explained the purpose of the visit.

During the course of the investigation, LPA G. Clark obtained information, collected documents and interviewed 2 staff. It was alleged facility staff did not assist resident with making a medical appointment. Based on Interviews with 2 staff, resident's social worker is responsible for scheduling resident's medical appointment. No forthcoming information provided by reporting party. Therefore, LPAs were unable to prove whether facility is responsible for scheduling resident's appointment or resident's social worker.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted. Due to technical difficulties, a copy of report is being provided via email.