Complaint Investigation Report

198602864-9-28-2022-11-AS-JHAD-CJQQXQ-20220929123351

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1000 CORPORATE DR #100

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

08/12/2022 and conducted by Evaluator Ana Soto

COMPLAINT CONTROL NUMBER: 11-AS-20220812094827

Facility is not addressing issues with insects.

This amended report supersedes report dated 08/15/22. Licensing Program Analyst (LPA) Ana Soto conducted a subsequent complaint investigation to deliver findings and decisions for the allegation listed above. Today’s complaint investigation was conducted with Gloria Somintac, House Manager.

The investigation consisted of following: Interviews, Record reviews, and tour of entire facility inside and out. On 08/15/22, LPA Soto interviewed Administrator, S#2, & S#3, R1 - R#3. LPA Soto received the following documents on 08/15/22: Resident roster, Staff roster, Estimate invoice for facility repairs.

Based on the LPA's investigation, the investigation revealed the following. Allegation 1 - Facility is not addressing issues with insects. Interviews with S#1, S#2, R#1, & R#2, they all agreed that the facility has had ants. The staff began to treat the entire facility by spraying (Raid.) LPA inspected the entire facility and found dead ants in room #2 and kitchen. In room#4 the staff had placed 4 ant baits to treat the ants. The facility is addressing the issue with the insects. The interviews and inspection conducted did not concur with the above allegation.