Complaint Investigation Report

197609715-10-6-2022-31-AS-RRAZ-CKPTP9-20221030145358

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

09/27/2022 and conducted by Evaluator Melissa Ruiz

COMPLAINT CONTROL NUMBER: 31-AS-20220927181551

Staff did not follow Covid-19 safety protocols.

On 10/6/2022 Licensing Program Analyst (LPA) Melissa Ruiz arrived at the facility to conduct an unannounced complaint investigation. Upon arrival, LPA was greeted by staff (S1) and S1 was observed to not be wearing a mask. S1 contacted the Administrator, who was unavailable, due to a family emergency. Administrator designated S1 to sign this report. At 11:25 a.m., LPA conducted a tour of the facility to ensure no immediate health and safety issues were present.

Allegation: Staff did not follow covid-19 safety protocols.

It is alleged that on 4/4/22, a credible witness visited the facility. During this visit, the credible witness was greeted by a staff member who did not screen the visitor for covid-19 symptoms. LPA interviewed the Administrator, to which she confirmed that sometime around April 2022, a random visit was conducted by the credible witness and a conversation with the credible witness took place regarding these observations. Based on the interview with administrator and LPA’s observation, this allegation is deemed Substantiated. Deficiencies issued per CA code of Regulations Title 22. Appeal rights issued. Report signed and delivered. Exit interview conducted.