Complaint Investigation Report

197607950-3-25-2022-31-AS-CHAS-CD9UBR-20220407152645

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

03/25/2022 and conducted by Evaluator Tuesday Cabiness

COMPLAINT CONTROL NUMBER: 31-AS-20220325084713

Staff did not attempt to locate resident after an extended period of time away from the facility

Licensing Program Analyst (LPA) Tuesday Cabiness conducted a complaint investigation and met with the Administrator Areyeh Rosner, and informed him the reason of the visit.

From 1230pm to 145pm, LPA conducted interviews with the Administrator and resident # 1 (R1), as well reviewed facility and resident records. On 03/22/2022, LPA reviewed an special incident report (SIR) that was sent to Licensing regarding R1 leaving the facility, and did not return. The report also revealed that R1 was assaulted and robbed by unknown individuals, and someone contacted 911. R1 was treated at the hospital. The Administrator reported to LPA that R1 and other residents are allowed to the leave the facility unassisted, and can come and go as they please. R1 has a history of leaving, and always returns within (2) days. Therefore, based information obtained from the Administrator and R1, the allegation is UNSUBSTANTIATED at this time.