Complaint Investigation Report

306005976-7-14-2022-22-AS-AORZ-CHSUPW-20220830154609

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

06/20/2022 and conducted by Evaluator Jenifer Tirre

COMPLAINT CONTROL NUMBER: 22-AS-20220620141344

Facility failed to provide records to family/attorney.

Licensing Program Analyst (LPA) Jenifer Tirre made an unannounced visit on this day for the purpose of delivering findings for the above mentioned allegation. LPA was greeted by staff and met with Caregiver Sandra Mattis.

Based on investigation interviews and documents reviewed, Licensee received letter for records on 6/16/22 with a two day due date. Licensee sent copies of records on 6/24/22. Investigation revealed that Licensee provided proof of sending records to family attorney and Family Attorney Represenative confirmed receiving records after due date. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are deemed UNSUBSTANTIATED.

An exit interview interview was conducted with Caregiver and copy of this report was left at facility.