Complaint Investigation Report

075601579-3-27-2023-15-AS-KHOS-CQJPF7-20230403111617

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

03/21/2023 and conducted by Evaluator James Sampair

COMPLAINT CONTROL NUMBER: 15-AS-20230321090125

Facility has key operated deadbolt on the facility front door.

On 03/27/2023 at 10:00 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to inspect facility concerning the allegation above. LPA explained purpose of the visit to staff S1 then and met with Licensee Donald Hay when he arrived at 11:30 AM.

During the visit, LPA interviewed staff and observed that the front door did have a key-operated deadbolt on the inside of the door. Based on the interview and observation, 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.