Complaint Investigation Report

157206907-9-13-2025-24-AS-SMOA-DMGLG4-20251015084404

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

09/10/2025 and conducted by Evaluator Mary Garza

COMPLAINT CONTROL NUMBER: 24-AS-20250910145849

Facility did not prevent physical abuse of resident

On 9/13/2025 Licensing Progarm Analysts (LPAs) M. Garza and L. Salazar arrived at facility for an unannounced initial complaint visit. LPA met with Medical Technician, Sony Moreno. Adminitrator, Nancy Montiano was contacted and gave permission to complete visit with Sony. Facility was not toured due to the population of unhoused and mental health residents.

During visit LPAs conducted interivews, requested and reviewed documentation (physicians reports, pre-placement appraisals, needs and services plans, hospital discharge records, emergency identification information). Inteviews with R1 disclosed they had an phycial altercation where R1 slapped R2. R1 stated it was due to R2 breaking the toilet and sink. The preponderance of evidence standard has been met per Title 22. The allegation above is SUBSTANTIATED. Deficiency cited per Title 22 on attached 9099D. If deficiency is not corrected it poses a direct impact on residents in care.

Exit interview completed with Medical Technician, Maria "Sony" Moreno. A copy of the report, deficiency and appeal rights have been provided.