Complaint Investigation Report

216803746-6-16-2022-21-AS-HDBI-CFU333-20220628175252

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

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

05/27/2022 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20220527080506

Staff failed to seek timely medical care for resident in care

Staff left resident in care in soiled undergarments for extended periods of time

Staff failed to inform physician of resident's change in condition

Staff failed to inform responsible parties of change in condition

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. Recent information confirms that the subject of this complaint is a resident of Three Home Village 3 and is not a resident of Three Home Village 2 This complaint was filed on the wrong facility due to a clerical error. Therefore, based upon this information, these allegations are UNFOUNDED, meaning that the allegations are false, could not have happened, or are without a reasonable basis. The COMPLAINT IS DISMISSED.