Complaint Investigation Report

197608711-2-8-2022-31-AS-EMIR-CBR2L4-20220217162857

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

03/12/2020 and conducted by Evaluator Alexander Pitz

COMPLAINT CONTROL NUMBER: 31-AS-20200312132701

Licensing Program Analyst (LPA) Pitz conducted an unannounced visit on this day in response to the above allegation.

As part of this investigation, on 3/13/20 LPA interviewed a staff member and collected relevant documents from Resident 1's (R1's) file. On 9/30/21 LPA interviewed the facility administrator and reviewed and obtained copies of additional client records.

Allegation #1, that "Resident has multiple pressure wounds," has been unsubstantiated based on the records reviewed and interviews conducted. LPA confirmed via the complainant that R1 was admitted to the hospital on 3/10/20 with multiple stage 1 and stage 2 pressure injuries. Staff 1 (S1) stated on 3/13/20 that R1 was receiving Home Health services for wound care, which LPA confirmed with a file review on 9/30/21 at 9:00a.m. at the facility. This is an allowable heatlh condition under Title 22 sections 87611 and 87631.

Report reviewed, signed and delivered. Exit interview conducted, no deficiencies cited.