Complaint Investigation Report

079200855-3-18-2022-15-AS-KHOS-CCRQ4T-20220322115051

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

03/27/2020 and conducted by Evaluator Daisy Panlilio

COMPLAINT CONTROL NUMBER: 15-AS-20200327115015

On 03/18/22 at 3:14PM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an unannounced subsequent complaint visit, met with executive director (ED) and delivered investigation finding of above allegation. LPA explained the purpose of the visit with ED.

Based on record reviews and interviews, resident (R1) was issued an eviction notice on 02/12/20 by former ED and resident moved out on 03/30/20. Review of SOC 341 dated 02/12/20 show a note from former ED advising CCLD of R1's 30 day notice of eviction.

Prior to R1 moving out, she was sent to the local hospital on 03/19/20 for diarrhea and vomitting. After treatment, she was released back to the facility. ED stated R1 moved out of the facility on 03/30/20.

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. Exit Interview conducted and a copy of this report provided via email.