Complaint Investigation Report

157209136-2-1-2024-24-AS-SPIY-D33R3U-20240305114028

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

01/23/2024 and conducted by Evaluator Lissett Padgett

COMPLAINT CONTROL NUMBER: 24-AS-20240123143251

Staff are not providing a safe environment for residents in care

LPA toured the facility with AD and observed a thick layer of unknown white powder in 4 resident bedrooms and under the kitchen stove. LPA interviewed staff and residents. Though there is discrepancy on what the purpose of the powder is for. Powder is accessible to residents in care.

Plan of Correction: LIcensee will remove powder from resdient rooms by POC date and will discontinue its use in this faclity going forward. Licensee will provide written statement on how Licensee will comply with this regulation.