Complaint Investigation Report

107209543-4-6-2026-24-AS-AWAN-DUQL9D-20260604083318

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

02/06/2026 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20260206133817

Due to lack of supervision, resident hit another resident

On 4/06/2026, Licensing Program Analyst (LPA) K. Kaur arrived unannounced to conduct a subsequent complaint inspection. LPA met with Administrator Maria Ceballos and announced the purpose of the visit. LPA delivered the following complaint investigation findings.

The Department investigated the allegations listed above. Based on observations, interviews conducted and records reviewed, due to lack of supervision, resident hit another resident. Incident happened during dinner when caregivers were busy getting meals from kitchen and assisting residents with feeding.

The preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. See citations on the attached LIC9099D. An exit interview was conducted with Administrator. A copy of this report, including appeal rights was provided to Administrator, whose signature on this form confirms receipt of this document.