Complaint Investigation Report

197609731-10-5-2021-31-AS-NMAN-CGAU95-20220713152233

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

08/07/2020 and conducted by Evaluator Alexander Pitz

COMPLAINT CONTROL NUMBER: 31-AS-20200807114542

Licensing Program Analyst (LPA) Pitz conducted an unannounced visit on this day in response to the above allegation.

During this investigation LPA conducted a virtual visit on 8/13/20 and interviewed the administrator and 3/5 residents; conducted an in-person visit on 10/5/21 and interviewed the administrator, 4/4 residents, and attempted to interview Resident 1 (R1) and their responsible party.

Allegation #1, that “Staff yelled at resident,” has been unsubstantiated based on the interviews conducted. No corroborating evidence was provided by the complainant, none of the interviews conducted on 8/13/20 or 10/5/21 corroborated the allegation. LPA was unable to obtain any other evidence or testimony to substantiate the allegation.

Report reviewed, signed and delivered. Exit interview conducted, no deficiencies cited.