Complaint Investigation Report
079200929-11-1-2021-15-AS-KHOS-CHCLMU-20220816085319
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
10/22/2021 and conducted by Evaluator Lizette Francisco
COMPLAINT CONTROL NUMBER: 15-AS-20211022082651
Facility failed to update resident's medical assessment
On 11/1/2021 starting at 2:00 PM, Licensing Program Analyst (LPA) L. Francisco arrived unannounced to conduct complaint investigation for the above allegation. LPA met with Administrator and explained the purpose of the visit.
During the complaint invesgiation, LPA reviewed records and interviewed Administrator. Based on information obtained, facility failed to update resident's medical assessment. During a Case Management visit on 10/18/2021, LPA reviewed two resident's (R1 and R2) physician's report and LPA observed R1's physician's report was last updated on 8/14/2020.
Based on LPAs observations and interviews which were conducted and record reviews, 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), are being cited on the attached LIC 9099D.
Exit interview conducted. Appeal rights and a copy of this report provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction