Complaint Investigation Report

107209543-8-19-2025-24-AS-AWAN-DRSQ9J-20260302105821

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

08/13/2025 and conducted by Evaluator Les Xiong

COMPLAINT CONTROL NUMBER: 24-AS-20250813164833

Facility did not take appropriate measures to safeguard resident's cash resources.

Licensing Program Analyst (LPA) L. Xiong conducted a complaint investigation visit to the facility. During the course of this complaint investigation LPA interviewed staff on duty and obtained and/or reviewed facility records. It was determined based on the interviews and records review that the above allegation is SUBSTANTIATED. The evidence from the investigation indicated that $200 was missing from resident #1's P&I money. It's uncertain on how it happened, however the facility will reimburse resident #1 for the missing amount. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.”)