Complaint Investigation Report

157206771-10-3-2023-24-AS-MHON-CZEM75-20240112082058

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

09/27/2023 and conducted by Evaluator Melinda Medina

COMPLAINT CONTROL NUMBER: 24-AS-20230927121508

On 10/03/23, Licensing Program Analyst (LPA) M. Medina conducted an unannounced initial 10-day complaint visit. LPA introduced self, stated purpose of visit, and allowed entrance by staff. Administrator contacted by telephone and arrived a short time later to conduct visit.

This department investigated the above allegation. During the course of the investigation, interviews were conducted and reviewed records.

Based on the interviews conducted, the preponderance of evidence standard has been met, therefore the allegation: Staff denied client entry into facility is found to be SUBSTANTIATED.

A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 9099D.

Exit interview was conducted and a plan of correction developed and reviewed. A copy of this report provided to Administrator for facility records.