Complaint Investigation Report

On the allegation: Facility did not report an incident(s) to parent/authorized representative

Based on interviews and records review, the facility did not report the incident of R1 falling and hitting their head on the floor to the residents responsible party. S1 stated that W1 was called and informed but documents do not list W1 as R1's responsible party.

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.