Complaint Investigation Report

306004798-5-16-2023-22-AS-SSAS-CS4V9Y-20230523161505

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

ORANGE & INLAND A/SC , 770 THE CITY DR., SUITE 7100

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

05/09/2023 and conducted by Evaluator Kevin Saborit-Guasch

COMPLAINT CONTROL NUMBER: 22-AS-20230509094358

Facility staff accidentally served toxics to facility residents, resulting in hospitalization

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of investigating the allegation listed above. LPA was greeted and granted entry by caregiving staff after introducing himself and stating the purpose of the visit. Administrator Josie Tehankee was present during the visit as she was supervising a tour for a prospective resident's family.

While at the facility, LPA conducted interviews with two staff members along with one witness. During the investigation, it was established that the incident of intoxication to individuals in care was reported at the wrong address and actually occurred at a facility observed to be located next door to the present facility at 26242 Avenida Calidad. During the visit, the facility was confirmed to not be licensed through the Department.

The allegation is therefore Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. The Department has therefore dismissed the complaint. An exit interview was conducted and a copy of this report was provided to the facility representative.