Complaint Investigation Report

306001408-10-10-2024-22-AS-AORZ-DA6LAD-20241018083459

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

04/26/2023 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20230426155340

Staff did not provide adequate supervision resulting in resident wandering away from facility

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to continue the investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.

During the course of the investigation, LPA toured the facility, interviewed Administrator as well as reviewed and obtained pertinent documentation such as physician report. Regarding the allegation that staff did not provide adequate supervision resulting in resident wandering away from facility, the investigation revealed the following: Resident 1 (R1) admitted into the facility on 03/31/2023 with a diagnosis of hypothyroidism. On 04/24/2023, Resident was discovered in the facility parking lot at approximately 3:00 AM after the exit door alarm had triggered. Resident was brought back into the facility with no injuries noted. Physician report dated 03/27/2023 indicated no cognitive impairment and resident is able to leave the facility unassisted. Based on interviews conducted and record review, the allegation is deemed unfounded, meaning the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted and a copy of this report was provided to facility representative.