Complaint Investigation Report

157209235-8-26-2024-24-AS-SMOA-D8SP7L-20240904110409

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

08/16/2024 and conducted by Evaluator Alexandria Walton

COMPLAINT CONTROL NUMBER: 24-AS-20240816164101

Facility staff did not respond to resident's ring bell

On 08/26/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to commence a complaint investigation. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA spoke with Administrator via telephone and received verbal permission to meet with

During the course of the investigation, LPA conducted a facility tour and interviewed staff. LPA confirmed did not hear the resident call button resulting in staff not responding timely to a residents call for assitance. Based on interviews the perponderance of evidence standard has been met therefore the allegation: Facility staff did not respond to resident's ring bell is SUBSTANTIATED.

A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 9099D. Exit interview conducted and a plan of correction was reviewed and developed. A copy of this report and appeal rights were discussed and provided to ************************, whose signature on this form confirms receipt of this document.