Senior Care Records.

Complaint Investigation Report

Cypress House, Oakley11/29/2023Licence 079200856

Census3
Date signed11/29/2023 03:33:29 PM
The inspector’s account

079200856-11-29-2023-15-AS-KHOS-CY8NLX-20231205093415

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

11/28/2023 and conducted by Evaluator Luisa Fontanilla

COMPLAINT CONTROL NUMBER: 15-AS-20231128150235

Facility staff were having inappropriate interactions in the presence of a resident

On this day at around 10:40 am, Licensing Program Analyst (LPA) Luisa Fontanilla arrived unannounced to conduct investigation on the above allegation. LPA met with Administrator Crystalyn Joseph and explained the purpose of the visit.

During the course of investigation, LPA interviewed the Administrator and 6 staff. LPA reviewed the following records: Lic 500, Client Roster, screen shot of text messages and staff contact information.

Based on interviews conducted, Administrator, S3, S4, S5 and S6 all denied knowing or witnessing S1 and S2 engaging in any inappropriate actions. S1 and S2 denied engaging in any inappropriate actions. Based on interviews conducted, the above allegation is unsubstantiated. 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.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction