Complaint Investigation Report

197609931-10-19-2022-31-AS-RRAZ-CLR47F-20221202175102

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

03/09/2021 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20210309154452

Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegation. LPA met with staff, Gloria Bisda and Augusto Lumanlan and advised them of the purpose of the visit. LPA spoke with the administrator, Clarita Zinkofsky over the telephone. Today's investigation consisted of interviews with residents and staff, a physical plaint inspection and record review. At approximately 9:30am-10:30am, LPA conducted a physical plant inspection. Between 10:30am-12:30pm, interviews made with staff, the administrator and residents. At approximately 12:30pm-1:30pm, LPA conducted a record review of facility records.

During the course of the investigation, LPA interviewed the administrator and two (2) of two (2) staff. They all denied the allegation. LPA interviewed five (5) of (5) residents, and all five could not confirm that the allegation had occurred. There were no witnesses identified to the allegation, and Resident 1 (R1) has since passed. Based on the information obtained, there was insufficient evidence to corroborate the allegation of resident being forced to eat. Therefore, the allegation is deemed Unsubstantiated at this time.