Complaint Investigation Report

331880723-4-6-2023-56-AS-KCLS-CQSU6K-20230411151828

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

10/12/2022 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20221012161059

Facility is not operating per fire clearance

Licensing Program Analysts (LPA) Bernadette Allen and Magda Malcore conducted an unannounced visit to deliver the findings on the above allegation. LPAs met with Adam Barone- Support Staff and explained the purpose of the visit.

The allegation: Facility is not operating per fire clearance. On 3/28/2023 LPA Allen arrived and met with Adam Barone and together we toured the facility. The tour included residents’ bedrooms to verify if the rooms are following the egress requirements for non-ambulatory residents. LPA observed that the rooms did not meet the egress requirements for non-ambulatory residents, and the door separating rooms 1 and 2 from the remainder of the living space should be permitted by the City of Beaumont Department of Building and Safety. Resident room 3 shall have a direct exit to the exterior in order to house non-ambulatory residents and the fire extinguishers shall be serviced annually.

Based on LPAs observation, interviews conducted and records review, the preponderance of evidence standard has been met. Therefore, the above allegation is Substantiated. This poses an immediate health, safety, risk to residents. LPA Allen informed the Adam of the corrections needed for compliance.

An exit interview was conducted with Adam Barone and a copy of this report, 9099D and appeal rights was provided.