Complaint Investigation Report

107209477-5-6-2025-24-AS-KHOS-DGNJBS-20250514065450

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

02/13/2025 and conducted by Evaluator Martin Vega

COMPLAINT CONTROL NUMBER: 24-AS-20250213162059

Licensee did not ensure facility was adequately staffed to meet resident’s supervision needs.

Staff did not respond to residents’ requests for assistance in a timely manner.

On 05/06/2025, Licensing Program Analyst (LPA) M Vega arrived unannounced to conduct a complaint investigation. LPA introduced self, stated the purpose of the visit to Administrator - Johnathan Sivilay.

LPA interviewed 2 out of 3 clients who denied staff taking too long. LPA also received a police report that stated, allegations of neglect to be unfounded. Based on documentation and interviews conducted allegations against the facility are unfounded.

This agency has investigated the complaint alleging Licensee did not ensure facility was adequately staffed to meet resident’s supervision needs and Staff did not respond to residents’ requests for assistance in a timely manner. We have found that the complaints are unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

No citations were issued at the time of this visit.

Exit interview conducted. A copy of this report was discussed and provided to Administrator - Johnathan Sivilay, whose signature on this form confirms receipt of this document.