Complaint Investigation Report

197610032-9-26-2022-31-AS-CHAS-CJSNRJ-20221001104138

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

07/08/2021 and conducted by Evaluator Melissa Spaeth

COMPLAINT CONTROL NUMBER: 31-AS-20210708103731

LEISURE GARDEN SENIOR ASSISTED LIVING FACILITY

Facility having resident sign up for services they don't need

LPA Spaeth conducted an unannounced visit and was greeted by Administrator. LPA stated the purpose of the visit was to present LPA's findings for the allegation, facility having resident sign up for services they do not need.

LPA Spaeth reviewed resident's file at 10:45 am until 11:05 am. LPA requested a copy of the hospice provider, Tulip Hospice, Inc, Informed Consent form. LPA observed resident's signature which shows the resident did consent for the hospice services.

Therefore this allegation is unsubstantiated. Exit interview was conducted, appeal rights discussed, and a copy of the report was given to the Administrator.