Complaint Investigation Report

107203505-9-21-2024-24-AS-SPIY-D9EMEP-20240924093305

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

04/12/2024 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20240412104750

Facility placed resident on hospice without authorization

On 9/20/24, Licensing Program Analyst (LPA) M. Medina conducted a subsequent unannounced complaint visit to gather additional documents and deliver complaint findings. LPA introduced self, stated purpose of visit, and allowed entrance by direct care staff. Shannon Steele contacted by telephone and arrived a short time later to conduct visit with LPA.

This department investigated the above allegation during the investigation, This department had insufficient information regarding the allegations listed above. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or disprove that the allegations occurred therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted. A copy of this report was provided to Administrator for facility records.

No deficiencies issued during this complaint visit.