Complaint Investigation Report

191201168-8-22-2022-31-AS-RRAZ-CJ77K4-20220911214318

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

08/12/2022 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20220812151323

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

A physical plant tour was done from 10-10:10am to ensure no immediate health and safety issues were present and none were noted during the tour

It is alleged that resident # 1 (R1) room has had bed bugs. LPA conducted an interview with the administrator regarding this allegation from 10:10-10:20am. LPA conducted an interview with R1 regarding this allegation from 10:20-10:30am. Information from interviews reveal that R1 has had continuous issues with bed bugs in their room. Orkin pest control came out to treat R1's room on 8/16/22, 8/17/22, and 8/18/22. R1's room did have live bed bugs and a deep cleaning was done and furniture that had bed bugs was thrown away and replaced. LPA also received documentation of past treatments that has been done by Orkin in not only R1's room but throughout the facility. Based on the information obtained this allegation is deemed Substantiated. Deficiency cited on LIC 9099 D. Civil penalty of 250 dollars is issued for a repeat violation of the same citation which was issued on 5/20/22. Exit Interview conducted, Appeal Rights explained. Copy of report issued.