Complaint Investigation Report

247208803-5-9-2022-24-AS-SMOA-CEKVYM-20220519165123

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

03/16/2022 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20220316170103

Neglect/ lack of supervision resulted in resident sustaining a fracture.

Resident developed pressure injuries while in care.

On 05/09/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit, and met with Administrator Maria Tostado.

The Department conducted interviews with staff, residents, and reviewed file and medical records. Per medical records reviewed, resident had a fracture that was age-indeterminate, therefore it is unknown whether it is an old or new fracture. Medical records also stated resident did not have any skin breakdown or wound/ulcer problems. Facility staff denied the allegations.

There is not a preponderance of evidence to prove the alleged violations did occur, therefore the allegations are Unsubstantiated. Exit interview was conducted. Copy of this report was provided to the Administrator.