Complaint Investigation Report

157209136-7-21-2022-24-AS-SMOA-CGXUCG-20220803152755

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

05/04/2022 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20220504083259

Facility staff hit resident with broom stick.

Licensing Program Analyst (LPA) K.Kaur conducted an unannounced complaint visit to deliver findings. LPA K. Kaur met with Staff/Medtech Barbara Martin and discussed the purpose of the visit.

In regard to the allegation Facility staff hit resident with broom stick, LPA K. Kaur interviewed residents, staff and, reviewed documents. LPA was unable to determine if the accusation occurred after investigation.

Although the allegations Facility staff hit resident with broom stick 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 allegation is UNSUBSTANTIATED.

Exit interview conducted. A copy of this report was discussed and provided to Medtech Barbara Martin, whose signature on this form confirms receipt of this document.