Complaint Investigation Report

107209439-11-17-2025-24-AS-SMOA-DNYUY6-20251202145925

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

11/10/2025 and conducted by Evaluator Jacques Leffall

COMPLAINT CONTROL NUMBER: 24-AS-20251110143727

Staff is not allowing resident to have her medications and personal property upon discharge

Staff did not ensure supervision was provided resulting in resident fall

On 11/17/25 at 9:15 am Licensing Program Analyst's (LPA) J. Leffall conducted an initial complaint visit to open and to deliver findings on above allegations. LPA met with Licensee (L1) Ron Camilo.

The Department conducted interviews with staff and reviewed facilty records.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is Unsubstantiated. No deficiencies were issued.

Exit interview conducted. A copy of this report was distributed to Administrator which confirms signature of this report.