Complaint Investigation Report

LPA found that 3 out of 8 residents sampled showed Activities of Daily Living (ADL) logs did not match the residents basic services as shown on the residents' Physician's Report for Residential Care Facilities for the Elderly form LIC602A.

The above allegations are substantiated. Deficiencies are being cited based on LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, see LIC9909D.

An exit interview was conducted and Plans of Corrections were reviewed and developed with the Administrator. A copy of this report and appeal rights were discussed and emailed to the email address on record with “Read receipt” to confirm receipt of this report.