Complaint Investigation Report

197607718-9-26-2022-11-AS-MVAO-CKCPHX-20221019112040

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1000 CORPORATE DR #100

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

09/21/2022 and conducted by Evaluator Jeremiah Randle

COMPLAINT CONTROL NUMBER: 11-AS-20220921164228

Facility staff is withholding resident's cash resources

On 9/26/2022 at 10:30 a.m. Licensing Program Analyst (LPA) Jeremiah Randle conducted an unannounced visit to deliver the findings of the complaint with the above allegation. LPA identified himself and discussed the purpose of the visit and the elements of the allegation(s) with Administrator Gwendolyn Craig. LPA conducted interviews with Administrator (S1) and reviewed documents from the facility such as admission agreement, discharge report, and resident's financial detail statement including any other pertinent documents such as undelivered closing check dated 9/14/2022 remaining in the file and not given to resident at discharge. Resident was discharged on 11/18/2021

Findings: Based on interviews and records reviewed, the preponderance of evidence standard has been met. LPA finds the alleged violation did occur; therefore, the allegation is SUBSTANTIATED.

The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. This poses a potential risk to Health and Safety or personal rights to clients/residents in care.

Exit interview held with Administrator Gwendolyn Craig. A copy of the report and appeal rights were provided.