Complaint Investigation Report

157203382-5-22-2025-24-AS-SMOA-DH3TV4-20250527150318

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

Staff advertently cause harm to residents.

On 5/22/25 at 2:00pm Licensing Program Analyst (LPA) J. Leffall conducted a subsequent complaint visit to 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.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is Unsubstantiated. No deficiencies were issued.

Exit interview conducted. A copy of this report was distributed to Staff which confirms signature of report.