Complaint Investigation Report

157208251-12-29-2025-24-AS-SMOA-DPXLDY-20260102074041

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

12/26/2025 and conducted by Evaluator Mary Garza

COMPLAINT CONTROL NUMBER: 24-AS-20251226135607

Staff did not ensure the facility was kept free of bed bugs resulting in injuries to client in care

On 12/29/2025 Licensing Program Analyst M. Garza arrived at the facility to complete an initial 10-day complaint visit. LPA met with Service Coordinator, Josie Medina and Program Director, Ron Cordy. LPA explained reason for visit and was permitted entry into the facility. LPA completed a tour of the facility and observed residents in common areas and outside.

During visit LPA completed interviews and obtained documentation (staff and client roster, discharge paperwork for R1, reviewed MARS and pest control receipt. The preponderance of evidence standard has been met per California Code of Regulations, Title 22. The complaint is SUBSTANTIATED. Deficiencies cited on attached 9099D.

Exit interview completed with Program Director, Ron. A plan of correction was developed by Ron and reviewed by LPA. A copy of this report, deficiencies and appeal rights were provided.