Complaint Investigation Report

197609728-2-3-2023-31-AS-MVAO-CWPU4D-20231017151457

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

09/06/2022 and conducted by Evaluator Melissa Spaeth

COMPLAINT CONTROL NUMBER: 31-AS-20220906154645

Resident sustained unexplained injury while in care.

LPA conducted an unannounced visit and was greeted by caregiver at the front door. LPA stated the purpose of the visit was to investigate the complaint which states staff physically abused resident in care and resident sustained unexplained injury while in care. The Administrator arrived at 8:10 am, LPA and the Administrator toured the facility at 8:20 am until 8;34 am. LPA did not observe any health or safety issues.

LPA interviewed the caregiver and one on one Brea Caregiver who both confirmed the resident (R1) incident occurred on September 5, 2022. Both stated R1 became upset and injured self the evening of September 5, 2022. Both confirmed that the Adminstrator was not at the facility. Based upon LPA's interview of the Administrator, the Administrator stated was not present at the facility on September 5, 2022. Also Complainant was unable to determine the specific date the event occurred and LPA interviewed the resident who was unable to provide information to LPA. Therefore the allegation is unsbustantiated.