Complaint Investigation Report

191290150-11-2-2022-31-AS-MVAO-CLWUTR-20221208145223

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

06/04/2021 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20210604100503

Client is causing harm to another client while in care

At approximately 10:30 a.m. on 11/02/2022 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced subsequent complaint visit. LPA met with the Administrator and disclosed the reason for the visit. Due to the COVID-19 pandemic, the facility has not reopened since closing on 03/13/2020.

From 11:15 a.m. to 12:45 p.m. LPA interviewed Administrator, Client #1 (C1), and Client #2 (C2). At 11:30 a.m. LPA conducted a records review.

Regarding the allegation above, it was alleged C2 hit and scratched C1 due to insufficient staff supervision. From interviews, the Administrator reported C1 had entered C2’s personal space. Without looking, C2 reached back and inadvertently pinched C1 on the arm. From record review, staff redirected C2 away from C1 and assessed C1 for injury. Staff also provided guidance to C1 about appropriate personal distancing and future social interactions. Based on interviews and record review, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANIATED at this time.

Exit interview conducted. Copy of report provided. Appeal rights discussed.