Complaint Investigation Report

198205095-1-14-2025-11-AS-UCOL-DD224Q-20250117160420

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

01/07/2025 and conducted by Evaluator Regina Cloyd

COMPLAINT CONTROL NUMBER: 11-AS-20250107131136

On 01/14/25, Community Care Licensing Division (CCLD) Staff conducted an unannounced complaint visit to the facility listed above. CCLD met with Administrator Antonia Dionisio and explained the purpose of today’s visit. During today’s visit CCLD reviewed the register of residents and interviewed Administrator/Staff #1 and Resident #1 (R1) over the phone.

The investigation revealed the following:

CCLD has investigated the complaint alleging staff mistreated resident. Register of residents (LIC 9020) revealed R1 did not live at the address listed above. Interview with R1 indicated R1 did not live at the address listed above. Interview with S1 indicated R1 has never lived at the adresss listed above. Based on record review and interviews, CCLD found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. An exit interview was conducted with Administrator Antonia Dionisio and a copy of this report was provided.