Complaint Investigation Report

197608053-5-21-2025-31-AS-EMIR-DH5U4L-20250529151519

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

N LA & CEN COA AC/SC , 21731 VENTURA BLVD., STE. 250

This is an official report of an unannounced visit/investigation of a complaint received in our office on

01/06/2025 and conducted by Evaluator Mariana Agban

COMPLAINT CONTROL NUMBER: 31-AS-20250106164839

Staff did not follow reporting requirements

Licensing Program Analyst (LPA) Mariana Agban conducted unannounced subsequent complaint visit to include additional interviews for the Substantiated complaint report on 1/15/25. LPA met with Administrator Marillen Basa and explained the reason for the visit. LPA conducted a physical plan tour, to ensure health and safety of the residents are protected and is in compliance with Title 22 Regulations. During today's visit, LPA interviewed 5 out of 5 residents. The allegations remain Substantiated.

Exit interview conducted, copy of this report delivered.