Complaint Investigation Report

107209083-4-18-2025-24-AS-SPIY-DGEQV6-20250506122950

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

01/30/2025 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20250130163529

Staff did not seek medical attention in a timely manner

On 4/18/25, Licesing Program Analyst (LPA) M. Medina and Licensing Program Manager (LPM) S. Pidgirny conducted an office meeting to deliver finding for complaint.

During complaint investigation, the facility was toured, interviews conducted and records reviewed.

Based on information gathered during investigation, resident 1 (R1) was not provided timely medical attention as needed. Administrator did not seek medical attention for R1 until told by placement agency.

The preponderance of evidence standard has been met,therefore the allegation of illegal eviction and licensee did not notify responsible person of incident is found to be SUBSTANTIATED.

A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 9099D.

Exit interview was conducted and a plan of correction developed and reviewed. A copy of this report provided to Administrator during office visit.