Complaint Investigation Report
The investigation consisted of the following:
On 04/04/2025, a facility tour was conducted, records were reviewed, and interviews were conducted. The facility tour consisted of Resident 1’s (R1s) room. Interviews consisted of 3 staff interviews [Staff 1 (S1) to Staff 3 (S3) were interviewed] and 1 resident interviews (R1 was interviewed). Facility records reviewed consisted of Personnel Report dated 01/2025, Register of Facility Residents dated 01/01/2025, Pest Control documents from 01/2025 to 03/2025. Resident 1 (R1) records reviewed consisted of Admission Agreement dated 01/01/2024, Physicians Report dated 06/13/2024, Appraisal & Needs Services Plan dated 01/28/2025, pictures of his room dated 3/20/2024, Record of Resident’s Safeguard Cash Resources for the year of 2025, etc.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction