Complaint Investigation Report

157206922-8-13-2024-24-AS-SPIY-D8MSRH-20240830140623

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

06/17/2024 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20240617104706

Staff allow more than two residents to share a bedroom

On 8/13/24, Licensing Program Analyst (LPA) M. Medina conducted an unannounced subsequent complaint visit to deliver findings. LPA introduced self and stated purpose of visit and allowed entrance by caregiver. Administrator contacted by telephone and arrived a short time later to meet with LPA regarding complaint findings.

This Department investigated the above allegation of staff allow more than two residents to share a bedroom. During facility tour on 6/29/24, LPA observed three beds in the master bedroom. Through information gathered during interviews, LPA was informed that there were previously 3 residents in the room, however one had recently moved out.

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.