Complaint Investigation Report

197608685-2-22-2022-31-AS-NMAN-CDQ25F-20220421170524

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

01/21/2022 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20220121083121

Staff did not safeguard resident's personal belongings

Licensing Program Analysts (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to the facility. Upon entry, LPA was screened for COVID 19 and met with Executive Director (ED) Johnny Ortiz.

--Staff did not safeguard resident's personal belongings

It was reported that Resident #1’s (R1) dentures were misplaced/lost and the facility staff felt that they should not be held responsible. During the investigation conducted on 01/24/2022 at 10:30am, LPA interviewed the reporting party. On 02/08/2022 at 11:00am, LPA requested facility records and interviewed the Executive Director (ED). LPA conducted a record review and discovered that the personal belonging in question was not listed on the Client/Resident Personal Property and Valuables Inventory Form which was signed and dated by R1’s responsible party.

Based on interviews and record review, there is no relevant information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.