Complaint Investigation Report

107209095-5-2-2023-24-AS-SPIY-CURRNJ-20230816131026

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

04/28/2023 and conducted by Evaluator Katie Brown

COMPLAINT CONTROL NUMBER: 24-AS-20230428155644

Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the initial 10-Day complaint investigation. LPA met with and explained the reason for the visit with Administrator (AD) Kym Jacobs.

During the visit, LPA interviewed AD and R1. Interviews revealed conflicting information as to the evernts that occured. Record review of R1's Individualized Program Plan (IPP) states that R1 has a history of fabricating incidents when R1 is upset. R1 received a 30 day eviction notice and has demonstrated increased aggitation and disruptive behaviors. Based on interviews and record review, the above allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur.

An exit interview was conducted and a copy of this report was emailed to AD during the visit.