Complaint Investigation Report

197609655-7-26-2022-31-AS-NMAN-CHKPSY-20220823113505

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-20220721123746

Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced complaint visit to investigate the allegation above. LPA met with the administrator and explained the reason for this visit.

LPA conducted a physical plant tour to ensure no immediate health and safety issues. LPA did not observe any health and safety issues.

It is alleged that when the facility has had visitors that staff did not wear mask or do any Covid-19 screening. During today's visit upon entry LPA's temperature was taken and LPA observed all staff to be wearing mask. Administrator stated that they did have a recent visitor and staff were not wearing mask but since then all staff have been wearing mask and covid-19 screening has been conducted with all visitors. Based on the information obtained through interviews this allegation is deemed Substantiated. Deficiency cited on LIC 9099 D. Appeal Rights explained. Copy of report issued.