Complaint Investigation Report

277209241-5-30-2025-24-AS-SMOA-DHBN4Q-20250604100816

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

05/29/2025 and conducted by Evaluator Jacques Leffall

COMPLAINT CONTROL NUMBER: 24-AS-20250529135712

Facility changed its Plan of Operation without Department Approval

On 5/30/25 at 2:00 pm Licensing Program Analyst (LPA) J. Leffall conducted an initial complaint visit to open and to deliver findings on above allegations. LPA met with Administrator (A1) Jessica Sanchez.

The Department conducted interviews and reviewed records. The records reviewed included the resident’s Admission Agreement and Eviction Notice that was issued to the residents. The Eviction Notice was not submitted to the Department and there was no proof that it was submitted. The facility is operating under a plan that was not approved by the Department.

The above allegations are Substantiated according to Title 22 Regulations and are cited on the attached 9099-D.

An exit interview was conducted and Appeal rights were provided.