Complaint Investigation Report

126803254-6-30-2022-21-AS-BMOS-CHDV44-20220817160544

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

06/08/2022 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20220608144646

At approximately 8:15AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to complete the investigation into the above allegation. LPA met with Health Service Director Angela Stevens, toured the facility and reviewed records. Based on interviews conducted and records reviewed, Housekeeping staff failed to clean several resident rooms for approximately 2 weeks. The error was corrected and housekeeping staff were retrained on the frequency of room cleaning.

Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with Angela Stevens and Appeal rights were given.