Complaint Investigation Report

157206689-9-28-2023-24-AS-MHON-CZEM6A-20240112081935

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

09/25/2023 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20230925093428

On 9/28/23, Licensing Program Analyst (LPA) M. Medina arrived unannounced to commence a complaint investigation. LPA introduced self, stated purpose of visit and allowed entrance by caregiver. Licensee, Evangeline Schissler arrived a few minutes later to conduct visit.

LPA toured facility, conducted interviews, and reviewed documentation. Based on interviews staff are not present at night, the preponderance of evidence standard has been met; therefore, the above allegation is found to be Substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D.

An immediate civil penalty of $500 is assessed.

Exit interview conducted. Exit interview conducted and a copy of this report was provided for facility records.