Complaint Investigation Report

197609720-2-13-2023-31-AS-RRAZ-CP96D4-20230220194228

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

12/05/2022 and conducted by Evaluator Melissa Spaeth

COMPLAINT CONTROL NUMBER: 31-AS-20221205133217

HAVENS AT ANTELOPE VALLEY ASSISTED LIVING, THE

Staff are not following COVID-19 protocols

LPA Spaeth conducted an unannounced visit with Administrator at 11:00 am. LPA stated the purpose of the visit was regarding the allegation, staff are not following COVID 19 protocols. LPA Spaeth interviewed reporting party on 12/14/2022 and asked for clarification regarding the allegation. The reporting party stated there are no issues and stated did not mention there were issues regarding COVID 19 protocols. Reporting party stated staff were properly wearing masks and following the COVID guidelines. Also, LPA interviewed twelve (12) residents on 1/09/2023 who stated staff were following the COVID-19 guidelines and residents did not have any issues regarding this allegation. Therefore the allegation is unsubstantiated.

Exit interview conducted and a copy of the signed report was given to the Administrator.