Complaint Investigation Report

197610136-9-18-2025-31-AS-NMAN-DPN33L-20251223165344

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

07/25/2025 and conducted by Evaluator Tihesha Smith

COMPLAINT CONTROL NUMBER: 31-AS-20250725084701

Staff did not ensure clients’ needs and services plan were followed

Licensing Program Analyst (LPA) Tihesha Smith made an unannounced subsequent complaint visit to this facility at approximately 10:15 a.m. on 09/18/25 to deliver findigs. LPA met with staff and disclosed the reason for the visit. The administrator was called and arrived later.

Staff did not ensure clients’ needs and services plan were followed

It was alleged that Staff did not ensure clients’ needs and service plan were followed. LPA review of resident’s records revealed all residents have a current Individual Service Plan (ISP) and/or an Individual Program Plan (IPP) on file. Interviews with six (6) of six (6) staff reveal they have reviewed residents’ needs and services plans to ensure they understand what residents’ needs are as well as communicating with the residents in care. During interviews with three (3) residents, all reported no concerns regarding the allegation.

Based on interviews, there is insufficient evidence to confirm the allegation Staff did not ensure clients’ needs and services plan were followed. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.