Complaint Investigation Report

197606838-2-2-2022-31-AS-NGID-CBVR4F-20220222114124

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

02/01/2022 and conducted by Evaluator Melissa Ruiz

COMPLAINT CONTROL NUMBER: 31-AS-20220201133520

Neglect resulting in unwtiness fall and bodily injury.

At 10:00 a.m. Licensing Progam Analysts (LPAs) Joscelyn Martinez and Melissa Ruiz conducted an unannounced initial complaint visit to this facility to investigate the above allegation.

LPAs were met by staff and later spoke to Administrator John Mallon telephonically. At 10:30 a.m., LPAs requested facility documents relevant to the investigation such as a current resident roster and LIC500. LPAs telephonically interviewed the Administrator and upon doing so, it was revealed that Resident #1 (R1) is not a resident at the facility nor has ever been a resident at this facility.

Due to this information, the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have dismissed the complaint. Since Administrator was not available at this time, Administrator designated staff Amorlina Comedia to sign the report. Report delivered. Exit interview conducted.