Complaint Investigation Report

079201325-10-18-2024-15-AS-YFLS-DDJVW4-20250203154718

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

09/12/2024 and conducted by Evaluator Alona Gomez

COMPLAINT CONTROL NUMBER: 15-AS-20240912154214

Resident sustained unexplained injuries while in care

On 9/20/2024 at 9:00AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to deliver findings for the allegations listed. LPA explained the purpose of the visit to Caregiver, Cathia Sheryll Delgado. Administrator was unable to attend and approved caregiver to sign report over the phone.

During the course of the investigation LPA interviewed 2 staff as well as spoke with medical staff (MS) associated to R1. S1 and S2 both stated that R1 would hit themselves on the wheel chair, try to jump through windows, hit doors, and hurt thyself with the accessories thereby leading to bruises. Medical staff stated that R1 has behavioral concerns and that they have been seen for on numerous occasions by the Psychiatric team. MS also noted that R1 acts out and gets aggressive and violent because they do not want to be in a RCFE. Based on the interviews of facility staff and medical staff both allegations are UNSUBSTANSIATED

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.