Complaint Investigation Report

197608267-3-30-2022-31-AS-TAGD-D7PKXY-20240731081813

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

03/25/2022 and conducted by Evaluator Joscelyn Martinez

COMPLAINT CONTROL NUMBER: 31-AS-20220325133246

Staff did not properly clean resident's room

Licensing Program Analyst (LPA) Joscelyn Martinez conducted an unannounced compliant investigation in regards to the allegations mentioned above . At 9:45 a.m. LPA Martinez arrived at the facility and was greeted by front desk staff. LPA later met with Administrator Aristotle Vergara. The purpose of this visit was explained.

To investigate these allegations, LPA Martinez interviewed ten (10) our of 108 residents. LPA Martinez also conducted interviews with four (4) staff members. Relevent documents were obtained.

Allegation: Staff did not properly clean resident's room. Interviews conducted between 10:30 a.m and 3:00 p.m determined that housekeeping did not properly clean Resident’s 1 bedroom (R1). Two staff member also confirmed that R1’s bedroom was not being properly cleaned. Based on these interviews and documentation, this allegation is Substantiated at this time.

Deficiency cited refer to 9099D. Report signed and delivered. Appeal rights issued.