Complaint Investigation Report

On 4/22/21 an office meeting was held with our department Community Care Licensing Division (CCLD) and other public agency during the meeting it was discuss the facility is to submit 2 out of 3 documents currently required for admission due to COVID 19; ALW Verification of Approval, Vaccination Card, and/or Declination of Vaccination before admission, the day of, or 24 hours after admission. LPA conducted document review for R1's date of admission is 7/22/21, facility added R1 to line list and schedule 1st dose of vaccination same day and emailed attachments of ALW and vaccination card on 8/4/21 after it was received from placing agency. R2's date of admission is 7/16/21, facility emailed attachments of ALW agreement and vaccination card on 7/16/21. R3's date of admission is 7/21/21 emailed attachments of ALW agreement and date of R3's schedule for 1st dose of vaccine. R4's date of admission is 7/30/21 emailed attachments of vaccination record noted facility was waiting for ALW documents on 7/30/21, facility email ALW document on 8/4/21 after receiving from placing agency. R5's date of admission 7/27/21 email attachments of ALW agreement letter and immunization record on 7/28/21. After review of documentation and emails it was observed facility was not able to submit all documents requested by public agency since facility was waiting for documentation to be send to the facility and it was submitted upon receiving it within 24 hours.

Based on LPA's records review conducted the preponderance of evidence standard has been met, therefore the above allegation(s) are found UNSUBSTANTIATED

Exit interview was conducted with Virginia Garcia administrator, and a copy of this report was provided.