Complaint Investigation Report

107206629-4-7-2022-24-AS-SMOA-CGHLDS-20220720084022

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

03/29/2022 and conducted by Evaluator Kelly J. McClurg

COMPLAINT CONTROL NUMBER: 24-AS-20220329092627

Assistant Administrator (AA) Maria Ceballos;

Resident unwitnessed fall was the result of lack of care and supervision.

A complaint visit was conducted on the date & time indicated above by Licensing Program Analyst (LPA) K. Mcclurg met with Assistant Administrator (AA) Maria Ceballos.

Incident reviewed & resident (R1) records reviewed. Incident reviewed with AA. Incident reported to the Department. Facility policy & procedures were followed. R1 did not sustain injury. R1 returned to facility same day.

The Department has investigated the above allegation & determined that it is unfounded.