Complaint Investigation Report

197609720-2-28-2022-31-AS-CHAS-CC6UTN-20220303145213

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

07/13/2020 and conducted by Evaluator Melissa Spaeth

COMPLAINT CONTROL NUMBER: 31-AS-20200713165406

HAVENS AT ANTELOPE VALLEY ASSISTED LIVING, THE

LPA Spaeth conducted an unannounced subsequent complaint visit to finish investigation into the allegation above. LPA met with the Andrea Gutierrez and explained the reason for this visit.

LPA's conducted a brief physical plant tour to ensure no immediate health and safety issues were noted. Regarding the allegation LPA Spaeth conducted resident interviews on 7/15/2020 and 12/01/2021 where interviews were conducted with facility staff and residents. Information from interviews reveal that ten out of the sixteen residents interviewed stated had to wait over thirty minutes for staff to respond to resident's request for assistance. Three residents stated when staff member did respond after a thirty minute wait, staff commented to residents that facility was short handed.

Based on the information obtained through interviews this allegation is deemed Substantiated. Deficiency cited on LIC 9099 D. Appeal rights were discussed, exit interview conducted, and a copy of the report was given to the Administrator.