Complaint Investigation Report
100400448-7-28-2026-24-AS-SMOA-DWTM89-20260810092245
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
07/22/2026 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20260722115844
On 07/28/2026 Licensing Program Analyst (LPA) M. Garza arrived at the facility for an unannounced complaint vsiit. LPA met with Assistant Director, Sara Guidry, explained reason for visit and was permitted entry into the facility. LPA completed a tour of the facility and Health and Safety check on residents in care.
During visit LPA completed interviews, gathered and reviewed documentation. Based on records reviewed and intervies conducted the preponderance of evidence standard has been met per California Code of Regulations, Title 22. The allegation listed above is SUBSTANTIATED. Deficiency cited on attached 9099D. If not corrected the deficiency will have a direct impact to residents in care.
Exit interview completed with Assistant Director, Sara. A plan of correction was developed by Assistant Director and reviewed by LPA. A copy of this report, deficiencies and appeal rights provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction