Complaint Investigation Report

275201878-10-24-2024-24-AS-BCHN-DACV4R-20241024160646

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

10/21/2024 and conducted by Evaluator Sarah Hurt

COMPLAINT CONTROL NUMBER: 24-AS-20241021092757

Facility staff did not provide supervision as necessary

Licensing Program Analyst (LPA) Sarah Hurt arrived at the facility unannounced on October 23,2024 at 04:15 .m. to investigate the above allegations. LPA met with facility Licensee Honesto Fernandez, and explained the purpose for today’s visit.

Regarding the allegation Facility staff did not provide supervision as necessary. The facility Licensee is leaving clients unsupervised while he leaves to pick up food for facility residents. Based on interviews conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

The following deficiencies are being cited Per Title 22 Regulations.

Exit interview conducted with Licensee Honesto Fernandez, and a copy of this report along with appeals rights provided.