Complaint Investigation Report

198601962-9-26-2022-28-AS-RORN-CJPNQS-20220928104022

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1000 CORPORATE CNTR DR. ST 500

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

09/20/2022 and conducted by Evaluator Kruz Long

COMPLAINT CONTROL NUMBER: 28-AS-20220920124636

Staff member pushed resident while in care.

Licensing Program Analyst (LPA) Kruz Long conducted an unannounced complaint visit to the facility. Upon arrival, LPA met with Victoria Tran (Administrator) and explained the purpose of the visit.

During today's visit, LPA obtained/reviewed a copy of the Staff/Resident rosters and interviewed Staff #1 in the office.

In regards to the allegation: Staff member pushed resident while in care. LPA interviewed Staff #1 who stated that Resident/Alleged Victim is not a resident of the facility and have never been a resident of the facility. Resident/Alleged Victim reside in the Skilled Nursing facility adjacent to this licensed facility. LPA reviewed the Resident roster and resident is not on the roster.

This agency has investigated the complaint alleging Staff member pushed resident while in care. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

Exit interview conducted with Victoria Tran and a copy of this report provided.