Complaint Investigation Report

197609060-10-6-2022-31-AS-RRAZ-CKPTDK-20221030143829

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

10/04/2022 and conducted by Evaluator Melissa Ruiz

COMPLAINT CONTROL NUMBER: 31-AS-20221004100310

Facility staff member was not wearing a mask.

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. At 12:30 p.m., LPA conducted a tour of the facility to ensure no immediate health and safety issues were present. S1 contacted administrator and LPA discussed the purpose of the visit with administrator.

Allegation: Facility staff member was not wearing a mask.

It is alleged that on 9/28/22, a credible witness visited the facility and the facility Administrator, Sunday Olowosagba and was observed to not be wearing a mask. LPA interviewed the Administrator, to which he confirmed that sometime around September 2022, a random visit was made by a credible witness who observed facility staff were not wearing masks and not screened upon entry. Administrator admitted that a verbal conversation with the credible witness took place regarding these observations. Based on interview with administrator, this allegation is deemed Substantiated. Report was signed and delivered. Deficiencies were issued per CA code of Regulations Title 22 on LIC9099-D with this report. Appeal rights issued. Report signed and delivered. Exit interview conducted.