Complaint Investigation Report

157206770-5-12-2025-24-AS-AWAN-DJFV3Y-20250710160531

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

05/07/2025 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20250507144632

Lack of supervision resulting in a resident inappropriately touching other resident(s)

Licensing Program Analyst (LPA) Shawna Doucette conducted a visit to commence a complaint investigation. LPA identified herself and discussed the purpose of the visit and the elements of the allegation and delivered findings to Administrator, Perla Pena.

LPA obtained copies of resident files, staff schedules, staff contact information and facility notes. LPA toured memory care. LPA interviewed staff and residents.

Based on interviews and records review, the Department has investigated the above allegations. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Administrator and a copy of this report was provided.