Complaint Investigation Report

157209376-10-1-2024-24-AS-SMOA-D9QKK5-20241004075744

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

07/16/2024 and conducted by Evaluator Alexandria Walton

COMPLAINT CONTROL NUMBER: 24-AS-20240716092733

Staff do not ensure that residents' dietary needs are met

Staff do not ensure that the facility is free from odor

Staff do not ensure that the facility is maintained sanitary

Staff are not able to communicate with residents to meet their needs

On 10/01/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with House Manager, Diana Diaz.

During the investigation, LPA conducted interviews and reviewed records. Based on record review and interviews, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to House Manager, Diana Diaz, whose signature on this form confirms receipt of this document.