Complaint Investigation Report

079200813-1-13-2023-15-AS-KHOS-CNDMC2-20230124082849

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

04/25/2022 and conducted by Evaluator Jill Clancy-Czuleger

COMPLAINT CONTROL NUMBER: 15-AS-20220425092910

Staff failed to treat resident with dignity and respect

Resident is not feeling safe at the facility

On 01/13/2023 starting at 01:02 pm, Licensing Program Analyst (LPA) J. Clancy-Czuleger arrived unannounced to conduct complaint investigation for the above allegation. LPA met with Amabelle Amparo, Administrator and explained the purpose of the visit.

During the course of investigation, LPA obtained information, collected documents and interviewed staff and residents. Based on interviews and record reviews the staff was assisting another resident with their nightly routine and asked R1 to leave the room so they could get ready for bed. Staff also stated that they have had many disscuions with R1 about not opening all of the doors for saftey reasons but R1 contiuned to do so.

Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted and a copy of this report provided.