Complaint Investigation Report

079200174-7-29-2022-15-AS-KHOS-CHBR95-20220815124858

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

07/20/2022 and conducted by Evaluator Daisy Panlilio

COMPLAINT CONTROL NUMBER: 15-AS-20220720135743

Insufficient staffing according to staff required by resident's care plan

On 07/29/22 at 1:30PM, Licensing Program Analyst (LPA) Daisy Panlilio arrived unannounced to conduct a complaint visit, gather information and deliver investigation findings to administrator. LPA explained the purpose of the visit with administrator.

During visit, LPA observed there were 2 Direct Service Professionals (DSP1, DSP2) assisting the 5 clients. Review of clients individual service plans show no one on one client requirement at the facility. Prior LPA unannounced visits on 02/28/22 and 11/05/2021 confirm 2 staff working at the facility.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies cited. Exit Interview conducted and a copy of this report provided via email.