Complaint Investigation Report

197608267-9-7-2022-31-AS-RRAZ-CK55DC-20221011195142

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

08/18/2022 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20220818174806

Expired food was left in resident's room.

Licensing Program Analyst(s) Wendell Smith and Joscelyn Martinez conducted an unannounced subsequent visit to finish investigation into the allegations above. LPA met with the administrator and explained the reason for this visit.

Initial visit was conducted on 8/25/22. During that visit interviews were conducted with staff and toured resident bedrooms. LPA also obtained copies of pertinent documents related to the allegations above.

Regarding the allegations above it is alleged that resident #1(R1) room #273 that there was expired food left in the room, that staff did not dispose of resident's trash, and that the room was unkempt and had a foul odor. During the course of the investigation LPA obtained pictures of room #273 which showed expired food and trash all over the room. Interviews with staff revealed that housekeeping was supposed to clean the room on once a week and that it was not done in room #273. Based on the information obtained through interviews and observation all four of these allegation are deemed Substantiated at this time. Deficiencies cited on LIC 9099 D. Appeal Rights explained. Exit Interview conducted.