Complaint Investigation Report

157202487-12-20-2021-24-AS-MHON-CD8L96-20220406083257

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

09/20/2021 and conducted by Evaluator Malia Thao

COMPLAINT CONTROL NUMBER: 24-AS-20210920111823

Facility staff handled resident in a rough manner.

On 12/20/21 at 11:35 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a complaint investigation. LPA explained reason for inspection and was granted entry. Licensee Helen Houck arrived a short time later.

LPA conducted interviews. During the course of the investigation, LPA conducted interviews, and reviewed records. Based on LPA’s interviews and records reviewed, there was not sufficient evidence to show facility staff handled resident in a rough manner or that facility staff restrained resident. The above allegations are unsubstantiated. The allegations may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted. As a COVID-19 precautionary measure, a copy of this report will be provided via email and an electronic read receipt confirms receiving this document. Licensee was informed to select yes when prompted to send a read receipt. Facility Representative signature on file.