Complaint Investigation Report

197608678-6-15-2022-31-AS-RRAZ-CJ4PAJ-20220909110846

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

06/03/2022 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20220603115538

Staff handled resident in a rough manner.

At approximately 9:55 a.m. on 06/15/2022 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced subsequent complaint visit. LPA met with staff and later administrator and disclosed the reason for the visit. Regarding the allegation above, it was alleged staff #1 (S1) pushed resident #1 (R1) out of the restroom. To investigate the allegation, LPA interviewed R1 and the administrator on 06/10/2022 from 8:00 a.m. to 1:00 p.m. and interviewed S1 on 06/15/2022 at 11:10 a.m. LPA also conducted a record review on 06/10/2022 at 12:40 p.m. From interviews, it was revealed that S1 pinched the sleeve of R1 to remove them from the restroom. Based on LPA’s interviews the preponderance of evidence standard has been met. The above allegation is therefore deemed to be SUBSTANTIATED at this time. California Code of Regulations (Title 22, Division 6, Chapter 8) are being cited on the attached LIC 9099-D.

Exit interview conducted. Copy of report and appeal rights provided.