Complaint Investigation Report

197601221-12-17-2021-31-AS-EMIR-CA82LW-20211230163014

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

09/07/2021 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20210907115151

Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent complaint visit. LPA met with the administrator and explained the reason for this visit.

LPA conducted a physical plant walk through and did not observe any immediate health and safety issues.

It is alleged that resident #1 (R1) was hit by staff # 1(S1)

Previous visits regarding the allegation above was conducted on 9/13/21 and 9/28/21 and interviews were conducted with all residents in the facility. A finding of Unsubstantiated was given on the allegation above. However after review by management it was found that more interviews needed to be conducted. During today's visit LPA conducted interviews with facility staff regarding the allegation above from approximately 11:45am-12:30pm. Information obtained through interviews with staff present reveal they have never witnessed R1 hit by S1 or any other staff. Based on the information obtained this allegation is still deemed Unsubstantiated as it was before. Exit Interview conducted.