Complaint Investigation Report

157209257-11-3-2023-24-AS-SMOA-CXM2V3-20231115164315

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

09/28/2023 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20230928144808

Annette Eggleston, Health Service Director

On 11/01/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver finding on the above allegation. LPA introduced self, announced the purpose of the visit, and met with Health Service Director (HSD) Annette Eggleston.

During the course of the investigation, interviews were conducted and records were reviewed. Interviews were conducted and records reviewed confirm R1’s son requested the facility to deny the resident back to the facility from the hospital.

Based on records reviewed and interviews which were conducted, the preponderance of evidence standard has not been met, therefore, the above allegation is found to be UNSUBSTANTIATED. An exit interview was conducted. A copy of this report was provided to the HSD, whose signature on this report confirms receipt of this report.