Complaint Investigation Report

Based on interviews conducted and documentation obtained, the preponderance of evidence standards has been met. Therefore, the above allegations is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiency is being cited on the attached 9099-D page. As a result of the resident's serious bodily injury, an immediate civil penalty per Health and Safety Code § 1548 in the amount of $500 is being assessed for a violation that the Department determines resulted in the injury or illness of a person in care. An additional civil penalty assessment is under review and determination is pending. LPA will return on a future date to assess an additional civil penalty if warranted.

Exit interview conducted. A copy of the report and appeal rights provided.