Complaint Investigation Report

107209116-2-17-2024-24-AS-BCHN-D36U45-20240308141432

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

11/17/2023 and conducted by Evaluator Vadim Gorban

COMPLAINT CONTROL NUMBER: 24-AS-20231117151834

Facility is not properly treating for cockroaches.

Facility floor surfaces are not maintained in an odorless condition.

On 2/16/24 Licensing Program Analyst (LPA) Gorban conducted subsequent visit to deliver findings.

LPA met with Administrator, Jeralyn Mai and stated purpose of the visit.

Allegations: Facility is not properly treating for cockroaches and Facility floor surfaces are not maintained in an odorless condition.

During the course of investigation LPA conducted interviews and record reviews. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Exit interview conducted, report signed and copy of this report provided to AD for facility records.