Complaint Investigation Report

157209417-8-12-2025-24-AS-AWAN-DKQVJS-20250820162913

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

06/20/2025 and conducted by Evaluator Jimmy Duarte

COMPLAINT CONTROL NUMBER: 24-AS-20250620140053

Staff rely on egress devices for memory care residents as a substitute for staff

Staff are not maintaining the facility free of odor

Staff do not ensure that residents are provided with activities

On 8/12/2025, Licensing Program Analysts (LPAs) J. Duarte and M. Medina conducted an unannounced subsequent complaint visit to conduct facility tour, interviews, gather documentation and deliver findings. LPA introduced self and stated purpose of visit and allowed entrance by direct care staff. Administrator, Jessica Pelaya present and conducted facility tour with LPAs along with Maintenance Supervisor, Nathan Villela. .

During the course of the investigation, facility was toured, interviews conducted and information gathered. This department had insufficient information regarding the allegations listed above. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or disprove that the allegations occurred;therefore, the allegations are UNSUBSTANTIATED.

No deficiencies issued during this complaint visit . Exit interview conducted. A copy of this report was provided to Administrator for facility records