Complaint Investigation Report

197609950-7-26-2022-31-AS-CHAS-CHS45K-20220829184804

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

07/21/2022 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20220721154956

Staff are not following guidelines to prevent the spread of COVID-19

Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced complaint visit to investigate the allegation above. LPA met with facility staff who contacted the administrator by telephone. LPA explained the reason for the visit to the administrator.

LPA conducted a physical plant tour from 9:15-9:25am to ensure no immediate health and safety issues. No health and safety issues were noted.

It is alleged that facility staff are not doing a covid-19 screening which include temperature checks on visitors. It is also alleged that staff are not wearing mask while providing care in the facility. Upon entry to the facility staff did not take LPA's temperature or perform a covid-19 screening. During the visit LPA observed home health come to the facility at approximately 9:50am and no covid-19 screening was done. LPA did observe one staff to be wearing a mask while another staff was observed to not be wearing a mask. Based on the information obtained through observation this allegation is deemed Substantiated. Deficiency cited on LIC 9099D. Appeal Rights explained and a copy of report was issued.