Complaint Investigation Report

107208838-5-6-2025-24-AS-SPIY-DGWM8Q-20250522092331

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

04/07/2025 and conducted by Evaluator Daiquiri Boyd

COMPLAINT CONTROL NUMBER: 24-AS-20250407133544

Facility did not provide resident file as requested

Licensing Program Analyst (LPA) Daiquiri Boyd conducted the subsequent complaint investigation visit to the facility. During the course of this complaint investigation LPA spoke with staff and obtained and/or reviewed facility records and emails. It was determined based on interviews and records review that the above allegation is SUBSTANTIATED. Facility did not provide a copy of the resident file as requested to the resident and/or resident's responsible party within 2 days as stated. Based on LPAs observations and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. Health and Safety Code 1569.269(a)(21) is being cited on the attached LIC 9099D.