Complaint Investigation Report

197609889-12-23-2021-31-AS-NMAN-CN6M7B-20230117082114

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

12/10/2021 and conducted by Evaluator Eleza Jackson

COMPLAINT CONTROL NUMBER: 31-AS-20211210153243

On this day Licening Program Analyst (LPA) Eleza Jackson conducted a facility tour to ensure no immediate health and safety issues were present. LPA Jackson did not observe any immediate health and safety issues. LPA Jackson met with the facility administrator upon her arrival at approximately 1430hrs and explained the reason for this visit.

It is alleged that the facility administrator hits residents in the facility. LPA Jackson was unable to locate former resident(s).

Based on the inability to locate former resident(s) this allegation is deemed Unsubstantiated at this time.

Exit interview conducted and copy of report emailed to administrator with signature.