Complaint Investigation Report

107209492-3-12-2025-24-AS-SMOA-DEVK9L-20250318074231

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

03/11/2025 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20250311151837

Licensee does not ensure that facility's appliances are maintained in good repair

On 03/12/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct initial complaint investigation. LPA introduced self, stated the purpose of the visit, and met with Administrator Karen Dhaliwal.

During the course of the investigation, LPA conducted interviews, toured the facility, and reviewed records. Refrigerators were observed operational and in good repair. Refrigerator temperature was maintained at 36 degrees F. Frozen food was observed stored in refrigerator. A freezer was observed in the facility kitchen non-operational.

Based on observation, interviews conducted, and records reviewed, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBTANTIATED. A copy of this report and appeal rights was provided to the Administrator, whose signature on this form confirms receipt of this report.