Complaint Investigation Report

331880723-10-19-2022-56-AS-KCLS-CMYVPJ-20230111153649

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1650 SPRUCE ST STE 200 MS29-27

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

10/14/2022 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20221014145046

Facility refused to accept resident back from the hospital

Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to the facility to investigate the above allegation. LPA met with Administrator-Caroline Armstrong and she was informed of the purpose of the visit regarding the above allegation.

Based on interviews conducted and review of records the resident (R1) doesn't not reside at this facility. The complaint that the facility refused to accept the resident (R1) back from the hospital was found to be unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. During the investigation the licensee said she had to leave and that Adam Barone could sign the report.

An exit interview was conducted, and a copy of this report was provided Adam Barone