Complaint Investigation Report

277209241-7-25-2025-24-AS-SMOA-DK9LJN-20250805084813

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

03/27/2025 and conducted by Evaluator Vadim Gorban

COMPLAINT CONTROL NUMBER: 24-AS-20250327101054

Staff are not adhering to residents contract

On 07/10/2025, Licensing Program Analyst (LPA) V. Gorban arrived unannounced to deliver findings on a complaint investigation. LPA explained the purpose of the visit to the administrator, and was allowed entry.

During the course of the investigation, LPA conducted a facility tour, conducted interviews, and reviewed records.

The Department has investigated the allegations: Staff are not adhering to residents’ contract. Based on LPA’s observations, interviews conducted, and record review the allegation is UNSUBSTANTIATED.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

Exit interview conducted. Report signed on-site. A copy of this report with appeal rights was discussed and provided to the facility representative.