Complaint Investigation Report

197609621-12-8-2022-31-AS-MVAO-CMXQSB-20230110112514

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

11/30/2022 and conducted by Evaluator Tuesday Cabiness

COMPLAINT CONTROL NUMBER: 31-AS-20221130143933

Facility staff served resident food with a screw in it.

Licensing Program Analyst (LPA) Tuesday Cabiness met with Administrator Monique Lopez and informed her the purpose of the visit. The following was determined:

From 10am to 1230pm, LPA conducted interviews and reviewed documentation pertaining to the allegation mentioned above. From information obtained, it was determined, that there were no witnesses to corroborate the allegation "Facility staff served resident with screw in it". LPA conducted interviews with numerous residents, including the interested parties involved with the complaint, and reviewed the photo of the screw, but LPA could not find sufficient evidence, the screw was in the food, on the alleged date. Also, it was revealed, staff were not notified until days after, and there were no complaints about the food on the alleged date to staff or the cook. Based on interviews and documentation reviewed, LPA could not find sufficient evidence to prove the allegation, therefore it is UNSUBSTANTIATED at this time.