Complaint Investigation Report

197609057-9-30-2022-31-AS-CHAS-CKN29H-20221028171157

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

09/29/2022 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20220929122756

Licensing Program Analyst (LPA) Wendell Smith made an unannounced complaint visit to investigate the allegation above. LPA met with facility staff and explained the reason for this visit.

Regarding the allegation above it is alleged that resident #1 (R1) was given another resident's medication by facility staff. LPA spoke with the administrator regarding this incident. Information from interview revealed that R1 does not reside in this facility but resides in Primrose (197609023) which is next door to this facility. Based on that a complaint will be written for Primrose (197609023) and this complaint will be Unfounded, means that the allegation is false, could not have happened, and/or is without a reasonable basis.