Complaint Investigation Report

157201087-10-10-2022-24-AS-MHON-CKAN55-20221017100857

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

07/13/2022 and conducted by Evaluator Malia Thao

COMPLAINT CONTROL NUMBER: 24-AS-20220713134030

On 10/10/22 at 8:35 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to deliver the findings for a complaint. LPA called Administrator (ADM) Gerald De Claro and explained reason for inspection. ADM arrived a short time later. No staff or residents present during the inspection.

During the course of the investigation, the Department conducted interviews and records review that revealed that R1’s admission to the hospital was unrelated to neglect. Based on such, the allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid there is not a preponderance of evidence to prove the alleged violation did or did not occur.

No deficiencies cited during this inspection.

An exit interview was conducted, and a copy of this report was left with Administrator Gerald De Claro, whose signature on this form confirms receipt of these documents.