Complaint Investigation Report

157208773-8-22-2023-24-AS-SPIY-CX8RPE-20231103131148

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

08/08/2023 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20230808083126

Staff did not respond to residents call for help

Staff are not properly cleaning ice machine

Licensing Program Analyst (LPA) S. Doucette and LPM S. Moua conducted a joint inspection. The above complaint allegations were discussed and reviewed with Administrator Ramona (Mona).

The Department toured the facility and checked the ice and juice machines. The juice and ice machines were observed with mold and required cleaning. During an inspection, LPAs observed a resident left outside calling for help. Resident is non-ambulatory and was in a wheelchair. The above allegations are Substantiated.

Deficiencies are cited on the attached 9099-D. Appeal rights were provided. Exit Interview was conducted.