Complaint Investigation Report

277209241-7-31-2025-24-AS-SMOA-DK9LKE-20250805084926

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

06/04/2025 and conducted by Evaluator Vadim Gorban

COMPLAINT CONTROL NUMBER: 24-AS-20250604143222

Facility staff is interfering with resident receiving notification and watching upcoming event

On 06/05/2025, Licensing Program Analyst (LPA) V Gorban conducted complaint commencement visit to the facility on above allegation. LPA met with Administrator (AD) Jessica Sanchez and stated the purpose of the visit.

During the course of the investigation, LPA conducted a facility tour, interviewed administrastor and residents.

The Department has investigated the allegation: Facility staff in interfering with resident receiving notification and watching upcoming event. Through interviews conducted with residents, it was discovered that facility staff interfered with residents receiving memo in mailboxes, although facility staff allowed resident to watch upcoming event. Based on observations and interviews, the preponderance of evidence standard has been met therefore the allegation is SUBSTANTIATED. A deficiency is being cited with civil penalty assessed on the attached LIC9099-D.

Exit interview conducted. Report was not signed. A copy of this report and appeal rights were discussed and provided to the facility records.