Complaint Investigation Report

157204130-1-18-2023-24-AS-SMOA-CNCMRY-20230123085105

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

12/22/2022 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20221222134955

Irma Langston, Assistant Executive Director

On 01/09/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct a subsequent complaint visit and delivered finding for the above allegation. LPA met with Irma Langston, Assistant Executive Director (AED) and announced the purpose of the visit.

During the course of the investigation, the Department conducted interviews, toured the facility and reviewed records. Ants were present and observed in residents’ room.

Based on interviews conducted, records reviewed and tour of facility, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 & Chapter 8, is being cited on the attached LIC 9099D.

An exit interview was conduct. A Plan of Correction was discussed with AED. A copy of this report and appeal rights was provided to the AED via email. Report signed on-site.