Complaint Investigation Report

306005159-11-22-2021-22-AS-AORZ-C9K3DF-20211209170924

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

11/16/2021 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20211116160346

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced initial 10 day complaint investigation. LPA was greeted and granted entry into the facility by House Manager Jeanette Silva and explained the reason for the visit.

During the course of the investigation, LPA interviewed staff and clients as well as reviewed and obtained pertinent documentation such as IPP and staff schedule. Regarding the allegation that client left unsupervised, the investigation revealed the following: Facility staff and Client 1 (C1) confirm the client was left alone in the facility. Witnesses states S1 left to go grab lunch and did not advise anyone the staff was leaving. C1 states this was a one time incident and verbalized feeling safe in the facility.

The preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6, Chapter 8). Exit interview conducted and a copy of this report was left at the facility as well as appeal rights.