Complaint Investigation Report

306005828-9-16-2022-22-AS-LADS-CJGQ9K-20220921115829

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 770 THE CITY DR., SUITE 7100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

11/04/2021 and conducted by Evaluator Albert Marin

COMPLAINT CONTROL NUMBER: 22-AS-20211104134318

Staff members are not adequately trained.

Licensing Program Analyst (LPA) Albert Marin made an unannounced visit to this facility to deliver the findings for the investigation completed for the complaint filed against this facility last November 4, 2021. LPA met with Administrator (AD) Lisa Roche and stated the purpose of this visit,

Based on file review, observation, and interviews, the following are the findings. On November 12, 2021, LPAs Marin and Haley initiated the complaint investigation and observed two staff members on the floor with six residents in care. LPAs did a review on medication and medication assistance procedure of the facility. Facility had provided training to staff members but unable to provide proof of training on medications to support current trainings. Based on the above findings, the preponderance of the evidence standard has been met. Therefore, the above allegation is found SUBSTANTIATED.

Deficiency was observed. Citation was issued per Title 22 Division 6 of the California Code of Regulations.

LPA Marin conducted an exit interview with AD Roche. LPA discussed deficiency, citation issued and appeal rights. Copy of this report was left in the facility.