Complaint Investigation Report

275202077-9-28-2023-24-AS-BCHN-CWFUL8-20231009154020

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

06/01/2023 and conducted by Evaluator Brianna Miranda

COMPLAINT CONTROL NUMBER: 24-AS-20230601135723

Staff do not ensure facility is kept in clean, safe, sanitary conditions for clients

On 9/26/23 at 10:05 a.m. Licensing Program Analyst B. Miranda arrived at the facility unannounced to deliver the finding for the allegations listed above. LPA introduced herself and explained the reason for the visit. Administrator (AD) RITA FAATUAI was contacted.

1. The Department investigated the allegation: Staff do not ensure facility is kept in clean, safe, sanitary conditions for clients. LPA toured the facility on 6/5/23 and found the men's bathroom to have a pungent urine smell. The floors also seemed to be sticky, LPA was unable to find the reason for the floor to be sticky, and staff was able to identify the reason.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 & Chapter 3, are being cited on the attached LIC 9099D.

Exit interview was conducted and a copy of this report LIC9099, LIC9099D, and appeal rights were printed and given to administrator RITA FAATUAI