Complaint Investigation Report

197601592-2-15-2022-31-AS-NGID-CD7L3F-20220405082349

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

02/14/2022 and conducted by Evaluator Angela Panushkina

COMPLAINT CONTROL NUMBER: 31-AS-20220214161532

Facility not following COVID-19 guidelines.

Licensing Program Analyst (LPA) Angela Panushkina conducted an unannounced initial complaint visit to this facility to investigate the above allegation. LPA met with the licensee, Walditrudez Lopez, who called the Administrator Vergilio Lopez and LPA explained the reason for the visit. Licensee left shotrly after.

Infection control: Upon arrival LPA was not screened by Consuelo Cipriano (staff) and was not asked any infection control questions. LPA had to prompt and guide staff through the screening process. Facility Mitigation Plan was incomplete and the LPA requested to re-submit it to Community Care Licensing Department (CCLD) for an approval.

Exit interview conducte, appeal rights explained and copy of this report emailed to the Administrator.