Complaint Investigation Report

157208939-8-8-2022-24-AS-SPIY-CH7KKU-20220811075855

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

05/11/2022 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20220511165258

Licensing Program Analysts (LPA) Shawna Doucette and Vadim Gorban contacted the facility to commence a complaint investigation and to deliver findings. LPA conducted a visit and took COVID-19 pre-cautionary measures. LPA's explained the purpose of the visit and the elements of the allegations with Licensee Michelle Ligon.

LPA requested copies of R1's file. Licensee stated she did not have a file for R1 due to R1 refusing to sign any documentation. Licensee gave the hospital documents of R1 to the placement agency. Licensee was able to provide R1's 602. LPA interviewed Licensee.

Based on the Departments record review and interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8, Section 87224(a) is being cited on the attached LIC 9099D.

An exit interview was conducted with Licensee Michelle Ligon and a copy of this report was provided.