Complaint Investigation Report

197609544-10-21-2022-31-AS-MVAO-CKUT37-20221104142151

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

10/10/2022 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20221010150155

Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent visit to finish investigation into the allegations above. LPA met with facility staff and explained the reason for this visit.

Regarding the allegations above it is alleged that staff #1 (S1) hit client#1 (C1) with a broom and handled C1 in a rough manner during an incident on 9/14/22. LPA conducted previous visits on 10/11/22 and 10/17/22. During those visits LPA interviewed facility staff and clients. During today's visit LPA conducted interviews with clients and staff from 4-4:30pm. LPA spoke with S1 by telephone regarding the allegations. Information obtained through interviews with clients and staff revealed that on 9/14/22 during an incident in the morning S1 was observed by two witnesses hitting C1 with a broom and handling C1 in a rough manner. Interviews conducted reveal that there were no injuries caused by the hit to C1. Based on the information obtained through interviews both of these allegations are deemed Substantiated. Deficiency cited on LIC 9099 D. Appeal Rights explained. Exit Interview conducted.