Complaint Investigation Report

107200877-10-7-2022-24-AS-MHON-CK5V4W-20221012160700

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

06/13/2022 and conducted by Evaluator Lisa Salazar

COMPLAINT CONTROL NUMBER: 24-AS-20220613090727

On 10/05/22, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver findings on the above allegation. LPA was greeted by Manager Virginia Jimenez, stated the purpose of the visit and was allowed entry into the facility.

During the investigation, LPA reviewed training records for staff. Based on LPAs observation of records review, staff do not have the required training hours to care for residents.

The preponderance of evidence standard has been met, therefore, the above allegation is found to be Substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D.

An exit interview was conducted with Administrator via telephone. A copy of this report and appeal rights were discussed and provided to Manager. A plan of correction was developed by Administrator and reviewed with LPA.