Complaint Investigation Report

336425681-10-16-2025-18-AS-APEZ-DMVKHP-20251028075528

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

RIVERSIDE ASC , 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

08/13/2025 and conducted by Evaluator Abdoulaye Zerbo

COMPLAINT CONTROL NUMBER: 18-AS-20250813142400

Staff refused to take resident back into care

Licensing Program Analyst (LPA) Abdoulaye Zerbo made and unannounced visit at the facility to deliver findings on the above allegation. LPA met with Licensee Dana Matei and discuss the purpose of the visit.

It was alleged that Staff refused to take resident back into care. Licensing program Analyst (LPA) Abdoulaye Zerbo conducted interviews with staff and the information obtained revealed the facility was not informed of the return of resident 1 (R1). The individual who returned the resident did not identify themselves, did not provide discharge documentation, and left the resident outside the facility without proper communication or hand-off. R1 was reportedly dropped off without a wheelchair, medication, or discharge paperwork. Additional information obtained revealed the individual who dropped off R1 refused to provide their name and left the scene abruptly.

Based on records review, resident interviews, and staff interviews, above allegation is Unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted, and a copy of this report was provided to Licensee Dana Matei