Complaint Investigation Report

071440165-5-16-2023-15-AS-KHOS-CVZR99-20230925124911

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

05/15/2023 and conducted by Evaluator James Sampair

COMPLAINT CONTROL NUMBER: 15-AS-20230515133330

Facility front door is equipped with a inappropriate lock

On 05/15/2023 at 8:20 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct an initial 10-day investigation regarding the above allegation. LPA explained the purpose of the visit to staff. Administrator Sara Abraham arrived at 10:45 AM.

LPA confirmed inappropriate lock on front upon entering facility. During a tour of the facility, 3 other sliding glass exit doors were "locked" in place with poles blocking movement of the glass door, thereby blocking exit.

When asked, Caregiver Claudia de la Cruz confirmed what had been stated by Complainant that it was used to block residents' exit. Based on the data collected by observation and interview, the preponderance of evidence standard has been met; therefore, the above allegation has been found to be SUBSTANTIATED.

Deficiency cited per Title 22 California Code of Regulations is listed on the LIC9099-D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted. Appeal Rights and a copy of this report provided via email.