Complaint Investigation Report

197602345-9-29-2021-28-AS-FFIS-C8WQ4H-20211119105023

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

09/22/2021 and conducted by Evaluator Mary G Flores

COMPLAINT CONTROL NUMBER: 28-AS-20210922105059

Residents engaged in a physical altercation while in care due to lack of supervision.

Licensing Program Analyst(s)(LPAs) Mary Flores and Jewel Baptiste conducted an unannounced complaint investigation visit regarding the above allegation. LPAs met with administrator Paula Digerness and explained the reason of the visit.

The visit consisted of the following: LPAs requested copies of resident and staff rosters, interviewed administrator, and wellness director. During the review of resident roster it was found that residents in question do not reside at the facility. LPAs proceeded to request a list of names of residents who had recently moved out of the facility or decease.

Based on the information gathered during this visit, the allegation is deemed UNFOUNDED.

A finding of UNFOUNDED means that the allegation is either false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted with Paula Digerness administrator and a copy of this report was provided.