Complaint Investigation Report

107209036-5-18-2023-24-AS-SPIY-CVPQ9E-20230915115808

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

05/16/2023 and conducted by Evaluator Katie Brown

COMPLAINT CONTROL NUMBER: 24-AS-20230516174446

Licensing Program Analysts (LPAs) Katie Brown and Mariam Flores arrived at the facility unannounced to conduct a 10-day initial complaint visit. LPAs introduced themselves and explained the purpose of the visit with Nathaniel Dominguez and Administrator Heidi Setty.

During the visit, LPAs toured the facility and conducted resident file reviews. LPAs requested and obtained a copy of resident files.

Due to insufficient information available at this time, the above allegations NEED FURTHER INVESTIGATION.

An exit interview was conducted and a copy of this report was left with Heidi Setty, whose signature confirms receipt of these documents.