Complaint Investigation Report

057005020-5-28-2022-27-AS-KHOS-CF8MB4-20220609092720

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 2525 NATOMAS PARK DR. STE.270

This is an official report of an unannounced visit/investigation of a complaint received in our office on

05/27/2022 and conducted by Evaluator Maja Jensen

COMPLAINT CONTROL NUMBER: 27-AS-20220527165904

On Saturday 5/28/22 Licensing Program Analyst ( LPA ) Maja Jensen arrived at facility unannounced to open a complaint investigation for the above allegation.

LPA Jensen investigated the same complaint allegation under complaint number 27-AS-20220426123415.

During the course of the investigation for complaint 27-AS-20220426123415. LPA Jensen reviewed records including but not limited to client files, staff roster, staff schedules, text messages and photographs. LPA Jensen also conducted interviews with 4 staff members, two administrators and 1 client.

Based on preponderance of evidence the allegation is SUBSTANTIATED. There are no deficiencies cited under this complaint. Per the California Code of Regulations, Title 22, deficiencies were observed and cited under complaint # 27-AS-20220426123415.

An exit interview was conducted and the report accompanied by the appeals rights was given.