Complaint Investigation Report

157209397-5-13-2024-24-AS-SMOA-D59LKZ-20240514085018

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

05/09/2024 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20240509161036

Uncleared staff providing care to residents

On 05/13/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an initial complaint inspection. LPA introduce self, stated the purpose of the visit, and met with Licensee 1 (L1) Jethronel Lazage. Licensee 2 (L2) Cecilia Lazaga arrived shortly.

LPA conducted interviews and received copies of records. Facility is licensed as of March 2024. S1 and S2 was at the facility prior to facility being licensed. All staff working at the facility are associated and fingerprinted cleared.

Based on LPA record reviewed and interviews which were conducted, the allegation of uncleared staff providing care to residents, the preponderance of evidence standard has not been met, therefore the allegation is found to be UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was provided to the L1, whose signature confirms received of this report.