Complaint Investigation Report

306004798-10-4-2021-22-AS-LADS-C7JSDB-20211006134651

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

09/30/2021 and conducted by Evaluator Albert Marin

COMPLAINT CONTROL NUMBER: 22-AS-20210930162454

Resident sustained an unexplained fracture while in care

Licensing Program Analyst (LPA) Albert Marin made an unannounced visit to this facility. LPA was granted entry after completing the Coronavirus 2019 (COVID 19) screening procedures. LPA met with Administrator (AD) Josephine Teehankee; and stated the purpose of the visit and the allegation indicated above.

LPA Marin toured the interior and exterior portions of the facility. LPA observed six residents in care and two staff members on the floor. LPA interviewed AD Teehankee; and review resident files. Based on file review and interviews, Resident 7 had never been a resident of this facility. Thus the allegation is unfounded.

This agency has investigated the complaint alleging that resident sustained an unexplained fracture while in care . We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

LPA Marin conducted an exit interview with AD Teehankee. AD gave permission for staff to sign and receive the report. LPA left copy of this report in the facility.