Complaint Investigation Report

197609022-9-4-2024-28-AS-EMIR-D8YTDB-20240910143801

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 21731 VENTURA BLVD., STE. 250

This is an official report of an unannounced visit/investigation of a complaint received in our office on

01/04/2023 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 28-AS-20230104121616

Staff did not seek medical attention for resident in a timely manner:

Licensing Program Analyst (LPA) Michael Cava conducted a subsequent visit to the facility to amend the 9099D page that was issued on 03/09/24. The above allegation was investigated by Investigations Branch (IB) Investigator Spindola. IB’s investigation consisted of interviews with the facility administrator, staff, and residents. IB’s investigation also included a review of R1’s medical records from the hospital and the skilled nursing facility (SNF) that R1 was discharged to. Based on the information that IB obtained, the allegation was Substantiated, which remains the same. The purpose of amending this report is to delete the continued citation, that was entered in the Plan of Correction (POC) box, and fit into the citations box. POC has since been corrected, therefore no further corrections will be needed. Office Manager advised and a copy of this report issued.