Complaint Investigation Report

had mold on the base. In the entrance to the kitchen LPA observed brown and black discoloration on the floor and bases of the door and wall. LPA also observed that the top of the kitchen refrigerator was covered with dust and the wall adjacent to it had brown and black discoloration and dust. On the right-side entrance to the kitchen LPA observed a cabinet with chipped paint, a ripped plastic cover and brown and black discoloration. Additionally, LPA observed that the cabinet above the stove had brown and black grease stains. The stove ventilation above the cabinet had brown and black discoloration and was covered withs dust and grease.

Based on LPA's observation and information gathered during the investigation, the preponderance of evidence standard has been met, therefore the following allegation: the facility is not being kept clean and sanitary is deemed SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8 is being cited on the attached LIC 9099D.

An exit interview was conducted with caregiver Hilahan Lopez and a copy of this report and the Appeal Rights were provided at the time of this visit.