Complaint Investigation Report

107203505-3-15-2023-24-AS-SMOA-CQ6STF-20230322140926

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

03/10/2023 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20230310144118

Administrator Susan Kendakur and Care Coordinator Luijean “Jean” De Castro Abragan

Resident was placed on hospice without proper consent or notice.

On 03/15/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an initial 10-day complaint inspection. LPA introduced self, stated the purpose of the visit and requested to meet with Administrator. LPA met with Care Coordinator Ong Vang. Administrator Susan Kendakur was called and arrived later during inspection. Care coordinator Luijean “Jean” De Castro Abragan arrived shortly. LPA discuss the complaint and delivered complaint finding on the above allegation.

During the course of the investigation, the Department conducted interviews, obtain copies of records, and toured the facility. Interviews was conducted with staff and resident. Based on the interviews conducted and records obtain, on 02/17/23, hospice agency discuss hospice with Resident 1(R1) and R1 have signed hospice contract. Based on interviews conducted and records reviewed, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UNSUBSTANTIATED. An exit interview was conducted. A copy of this report was provided to Administrator.