Complaint Investigation Report

197609870-5-12-2022-31-AS-EMIR-CESNNE-20220526103638

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

04/27/2021 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20210427143638

Facility staff did not adequately supervise resident in care.

Licensing Program Analyst (LPA) Wendell Smith conducted an initial complaint visit to this facility to investigate the allegation above. LPA met with administrator Saleem Mohammed and explained the reason for this visit.

It is alleged that client #1 (C1) has left the facility unattended on at least two occassions unsupervised. LPA conducted an interview with the administrator regarding this allegation from 10:05-10:25am. LPA reviewed C1's facility file which included C1's Individual Program Plan (IPP) from 10:30-10:45am. A review of C1's IPP revealed that C1's needs supervision when outside of the facility. Interview with administrator revealed that C1 did leave the facility unattended and went across the street. Administrator has notified North Los Angeles Regional Center about the incident. Administrator has spoken with Regional Center about C1 receiving one on one services. Based upon the information obtained this allegation is deemed Substantiated. Deficiency cited on LIC 9099 D. Appeal Rights explained. Exit Interview conducted.