Complaint Investigation Report

157203382-5-22-2025-24-AS-SMOA-DH3TV3-20250527150317

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

05/19/2025 and conducted by Evaluator Jacques Leffall

COMPLAINT CONTROL NUMBER: 24-AS-20250519155637

On 5/22/25 at 2:00 pm Licensing Program Analyst (LPA) J. Leffall conducted an initial complaint visit to investigate and deliver findings on above allegations. LPA met with Staff (S1) John Kevin Clemeno and stated purpose of visit.

The Department reviewed records and conducted interviews. R2 stated staff has yelled at resident.

Based on the interviews conducted, the preponderance of evidence that Staff yelled at Resient is substantiated. Citation is issued on the attached 9099D.

Exit interview conducted. Appeal Rights were provided.