Complaint Investigation Report

079200355-10-7-2021-15-AS-KHOS-CKBMPU-20221018094742

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

09/27/2021 and conducted by Evaluator Lizette Francisco

COMPLAINT CONTROL NUMBER: 15-AS-20210927155339

Staff did not intervene in verbal altercation between residents.

On 10/7/2021 starting at 10:20am, Licensing Program Analysts (LPAs) L. Francisco and J. Clancy-Czuleger arrived unannounced to conduct complaint investigation for the above allegation. LPAs met with Executive Director, Akindele Omole and explained the purpose of the visit.

During the course of investigation, LPAs obtained information, collected documents and interviewed 7 staff and 5 residents. Based on interview with staff (S6), it was revealed S6 did not intervene during verbal altercation between two residents.

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.