Complaint Investigation Report

125000579-12-24-2021-21-AS-CMAZ-C9ZMWD-20211224085810

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 101 GOLF COURSE DR. STE. A-230

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

10/25/2021 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20211025162155

Staff did not seek timely medical for resident in care

**Amended** LPA amended 9099 to correct the allegation above. Nothing was changed in the body of this document. Signature scanned over from licensee for change. At approximately 8:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived to this facility unannounced, to conduct an investigation into the above allegation. LPA met with Administrator Winne Mereb and Licensee Larona Farnum, interviewed staff, toured the facility and reviewed records. The incident was in regards to a resident being found on the floor of their bathroom, unresponsive. Facility contacted emergency personnel immediately and Hospice was notified. Resident was pronounced deceased at the facility. LPA reviewed resident call log history. Response times ranged from under 1 minute to 8 minutes. Facility followed regulation and notified all responible parties as required by regulation.

This agency has investigated the above allegation. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.