Complaint Investigation Report

197607537-9-27-2022-31-AS-RRAZ-CKPM77-20221030092102

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

09/20/2022 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20220920133535

Staff are not screening visitors regarding Covid-19 guidelines

Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to the facility. LPA met with, the licensee, Alan Hurtado and explained the reason for the visit.

--- Staff are not screening visitors regarding Covid-19 guidelines

It was alleged that staff are not wearing masks and are not screening visitors. To investigate this allegation, on 09/27/2022, LPA made observations during a physical plant tour at 9:45 AM and interviewed two (02) staff from 10:35 – 11:05 AM. LPA observed that all staff were not wearing masks and LPA was not screened upon entry. During the interviews, staff admitted to not following infection control protocols. Based on observations and interviews, the allegations are SUBSTANTIATED at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D):

Exit interview was conducted and a copy of report was issued.