Complaint Investigation Report

236804090-4-7-2025-21-AS-KMOA-DFTU3Q-20250417151356

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

12/13/2024 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20241213170036

Staff are not providing first aid to resident

Staff did not ensure resident received medical care

At approximately 11:00AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegations. LPA met with Administrator Isaac Rolle, toured the building and reviewed records. Based on records reviewed and interviews conducted, LPA was not able to find evidence to support the allegations listed above. LPA reviewed home health documentation and did not find an order for creams for a foot injury. Creams ordered were documented in facility medication documentation. LPA reviewed documents regarding resident medical care. LPA observed facility submitted special incident reports regarding a resident fall. The incident report stated emergency services were contacted. LPA reviewed resident records and observed hospital discharge paperwork regarding medical care from the fall.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.