Complaint Investigation Report

157200632-11-6-2024-24-AS-SPIY-DB6MK5-20241119084008

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

07/23/2024 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20240723120101

SVS BAKERSFIELD SOUTHWEST ADULT DAY PROGRAM

Staff did not provide adequate care and supervision to a client

Licensing Program Analyst (LPA) Shawna Doucette arrived unannounced to deliver findings complaint investigation. LPA was granted entry by Staff Xinia Ulloa. LPA met with Regional Directior Latisha Albritton.

LPA reviewed C2's IPP and LIC 602. Facility was unable to provide a copy of the Admissions Agreement for C2.

Based on interviews and records review, C2's IPP states client requires constant supervision due to safety concerns. C2's medical records indicate C2 obtained a fracture.

Based on the Departments interviews and records review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, is being cited on the attached LIC 9099D.

A copy of this report along with plan of correction and appeal rights were provided to the Regional Director.