Complaint Investigation Report

157208773-2-2-2022-24-AS-MHON-CBXM23-20220224081249

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

12/02/2021 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20211202110000

Facility accepted resident who needed higher level of care as the result of not conducting proper pre-assessment.

Facility rooms do not provide for easy passage for residents who use wheelchairs.

Resident had several unwitnessed falls as the result of insufficient staffing.

On 02/02/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver complaint findings on the above allegations. LPA met with Administrator Ramona Eleco and stated purpose of visit.

During the course of the investigation, the Department conducted interviews, toured the facility and reviewed records. LPA reviewed resident’s and facility record which show proper pre-assessment was conducted prior to accepting the resident to the facility. Resident’s physician report, California Assisted Living Waiver program (ALW), and assessment were reviewed and confirmed resident did not need higher level of care. LPA toured facility and observed doorways to have proper passage. Records were review and staff interviews confirm adequate staffing.

Based on records reviewed, observations, and interviews which were conducted, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Exit interview conducted. As a COVID-19 precautionary measure, a copy of this report will be provided via email. Report signed on-site.