Complaint Investigation Report

075600354-7-29-2024-15-AS-HHUL-DCXLZ4-20250115081115

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

07/22/2024 and conducted by Evaluator Grace Luk

COMPLAINT CONTROL NUMBER: 15-AS-20240722123621

Staff did not allow authorized representative to view the menu

On 7/29/2024 at 10:00AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings regarding the allegation above. LPA met with caregiver, Aproniana Gionson and informed her of the reason for the visit. Administrator, Epifania Angcla arrived 30 minutes later.

During the course of investigation, LPA interviewed 2 resident, 2 staff, and complainant. Interview with staff revealed that facility does not have a sample menu available.

Based on LPA's information obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, are being cited on the attached LIC9099D. Exit interview conducted. A copy of this report and appeal rights provided.