Complaint Investigation Report

107209035-10-21-2025-24-AS-SMOA-DMVM4H-20251028091645

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

10/20/2025 and conducted by Evaluator Jacques Leffall

COMPLAINT CONTROL NUMBER: 24-AS-20251020133934

Staff not providing resident with meals in a timely manner.

Staff not providing adequate food service.

On 10/21/25 at 1:00pm Licensing Program Analyst's (LPA's) J. Leffall and B. Miranda conducted an initial complaint visit to open and to deliver findings on above allegations. LPA met with Administrator (A1) Michelle Ramos.

The Department conducted interviews with staff, and residents.

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.