Complaint Investigation Report

317004560-6-20-2022-25-AS-MSEY-CFSKTM-20220627081119

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

04/04/2022 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 25-AS-20220404165705

Facility staff failed to protect client from injury at the day program.

On 6/20/22, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with clinical staff. Prior to initiating the complaint visit, LPA completed required COVID-19 testing and screening protocol. Upon arrival, completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA was screened with temperature and symptom check at the facility.

LPA conducted records review and interviews.

LPA is unable to find and or meet the preponderance, per policy.

R1 was unable to communicate where the injuries under investigation occurred.

Evidence was not found to explain the injuries cause, time or place.

As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview with VP of Operations.