Complaint Investigation Report

157209178-6-21-2022-24-AS-MHON-CFSPBV-20220627111056

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

06/10/2022 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20220610150816

PURPOSEFUL RESIDENTIAL CARE: HASWELL PLACE

On 6/21/2022, Licensing Program Analyst (LPA) M. Medina conducted a subsequent visit to facility to investigate complaint. LPA identified herself and discussed the purpose of visit with Administrator, Adonica Vickers.

LPA conducted interviews, and reviewed facility video footage during complaint investigation. Based on interviews, and observation of video, there is insufficient evidence that allegations occurred.

Although the allegation 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.

Exit interview conducted. No deficiencies cited.