Complaint Investigation Report

075601160-3-6-2025-15-AS-KHOS-DFAN3Y-20250331100707

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

02/10/2025 and conducted by Evaluator Jill Clancy-Czuleger

COMPLAINT CONTROL NUMBER: 15-AS-20250210154802

Licensee did not ensure the facility had power

On 3/6/2025 at 9:00AM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger and Y. Brown arrived unannounced to deliver findings for the above allegations. LPA explained the purpose of the visit with Caregiver Dennis Ambat. Administrator Stew Morris was informed of the visit.

On the allegation: Licensee did not ensure the facility had power. LPA interviewed staff, residents and witnesses about the loss of power in February 2025. LPA was informed that the facility was without power for over a week and because the licensee did not pay the bill. During this time no alternative power resource was provided during the outage.

Based on LPAs interviews, 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), is being cited on the attached LIC 9099D.

Exit interview conducted. Appeal Rights and a copy of this report provided.