Complaint Investigation Report

312701026-5-20-2022-25-AS-LMUZ-CF9NR3-20220610104051

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 520 COHASSET RD., STE. 170

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

03/07/2022 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 25-AS-20220307135328

Staff is not following public health mask requirement.

On 03/17/22, during interview with administrator, administrator stated that he was under the impression that with the new guidelines, fully vaccinated and boosted staff for Covid-19, were not required to wear a mask inside the facility. LPAs advised the administrator that this information is not correct and wearing of face mask still required inside the facility despite vaccination status and exemption.

LPAs observed during 03/17/22 visit that staff were not wearing masks while caring for residents in care.

Due to interview conducted with administrator and LPAs' observation during 03/17/22 visit, per California Code of Regulations, Title 22 Division 6, Chapter 8, deficiencies are being cited on the attached 809-D page.

Exit interview was conducted with Administrator and a copy of this report and appeal rights were provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.