Complaint Investigation Report

157208773-1-18-2023-24-AS-SMOA-CNGW5K-20230127155913

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

01/17/2023 and conducted by Evaluator Mary Garza

COMPLAINT CONTROL NUMBER: 24-AS-20230117132733

On 1/18/2023 Licensing Program Analysts (LPAs) M. Garza and L. Salazar arrived at facility to completed an unannounced initial complaint visit. LPAs introduced selvesand were permitted entry into facility. LPAs were not COVID pre-screened upon entry. LPAs met with Administrator, Ramona Eleco and discussed reason for visit. LPAs completed a health and safety check on residents in care. Residents observed in common areas and in rooms.

During visit LPAs completed interviews with staff and residents. LPAs requested a staff and resident roster with contact information. Rooms toured were observed to be in need of repair. Rooms 29, 43 and 48 are not functioning and or not funtioning properly. The allegation listed above is found to have occurred and the preponderance of evidence has been met per Title 22. The allegation is SUBSTANTIATED. Deficiencies cited on LIC 9099D. Exit interview completed with Administrator, Ramona Eleco. A copy of this report and appeal rights have given.