Complaint Investigation Report

197606737-12-12-2022-31-AS-NGID-CMCN54-20221222090853

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

11/03/2022 and conducted by Evaluator Joscelyn Martinez

COMPLAINT CONTROL NUMBER: 31-AS-20221103152702

On 12/12/22 Licensing Program Analyst (LPA) Joscelyn Martinez arrived at the facility to conduct an unannounced subsequent complaint investigation. Upon arrival LPA met with administrator and the purpose of the visit was explained.

Allegation: Staff records are not accurate.

It is alleged that the facility is still using former staff records. To investigate this allegation LPA conducted interview with Administrator Fransicsca on 11/08/22. Interview revealed that facility does not use records from former staff. Records are archived at the facility which according to regulations files need to be retained for three years after termination. LPA observed former staff files in a cabinet that were archived, and current staff files where located in a separate location in the office area. LPA collected staff file and a current Personnel Report (LIC 500) Based on interview, this allegation is deemed Unsubstantiated.

Exit interview conducted. Report signed and delivered.