Complaint Investigation Report

306005779-12-13-2021-22-AS-MSTC-CKV4UJ-20221104192447

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

12/09/2021 and conducted by Evaluator Michelle Reed

COMPLAINT CONTROL NUMBER: 22-AS-20211209113141

Facility Administrator failed to assist Resident #1 with his financial benefits.

Licensing Program Analyst Michelle Reed arrived at the facility to discuss the complaint allegation. Upon arrival, LPA met with Staff Christian Yugale, Teddy Santos and Elmer Hahn. LPA spoke with Administrator Delia Collantes via telephone and explained the purpose of the visit. Ms. Collantes stated that she was not feeling well and could not come to the facility. Assistant Administrator Dante Benevicto arrived a short time later. A tour of the physical plant was conducted and records were reviewed. Resident #1(R1) was admitted into the facility as an emergency placement on 7/23/21. Upon admission, Administrator Delia Collantes was directed by Orange County Regional Center to assist R1 with a change of address and his Social Security benefits. As of today's date Ms. Collantes has not provided assistance and R1 has not received his P & I funds.

Based upon interviews and records, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. See LIC9099D for cited deficiencies. An exit interview was conducted with Dante Benevicto and a copy of this report and appeal rights were provided.