Complaint Investigation Report

300600977-7-10-2025-22-AS-AORZ-DJPUSN-20250718155036

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

07/01/2025 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20250701140411

Facility failed to provide notice to resident when changing room location

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to initiate an 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 and interviewed staff and resident as well as reviewed and obtained pertinent documentation such as facility notes. Regarding the allegation that facility failed to provide notice to resident when changing room location, the investigation revealed the following: Resident 1 (R1) was moved from Independent Living to Assisted Living on 12/23/2024 due to ongoing health issues. Resident indicates agreeing to the move and facility notes confirm the agreement. Resident confirmed needing additional assistance from staff and had been having the conversation with staff about moving due to mobility issues and hip pain. Resident was re-assessed on 12/18/2024 and provided an updated service plan on 12/23/2024. Physician report dated 12/23/2024 indicates resident is diagnosed with Osteoarthritis. LPA observed resident's room to be clean and in order. Therefore the allegation is deemed UNFOUNDED, meaning that 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.