Complaint Investigation Report

277209241-3-20-2026-24-AS-SMOA-DSGLXY-20260324090930

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

09/16/2025 and conducted by Evaluator Vadim Gorban

COMPLAINT CONTROL NUMBER: 24-AS-20250916085905

Staff do not ensure kitchen is cleaned properly

Staff do not ensure food is at proper temperature

On 03/20/2026, Licensing Program Analyst (LPA) V Gorban visited the facility regarding complaint investigation and deliver findings. LPA met with administrator and explain the purpose of the visit.

During multiple visits of this complaint investigation, LPA conducted a tour of the facility, interior and exterior to ensure there is no potential or immediate health and safety risk at the facility, documents were reviewed, interviews conducted, and information gathered.

Allegation: Staff do not ensure kitchen is cleaned properly and Staff do not ensure food is at proper temperature. Based on observation during facility visits on 09/16/ and 12/30/25 LPA interviewed staff, administrator, and residents which revealed the above allegation is Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or disprove that the allegations occurred.

Exit interview conducted, report signed and copy of this report provided to administrator for facility records.