Complaint Investigation Report

For the allegation, Staff are not reporting incidents: During staff interviews, S1 informed LPA that they have been submitting incident reports to Community Care Licensing. However, based on record review, LPA Rico observed that the facility has not been submitting incident reports to Community Care Licensing. The last incident report submitted to the Department was in 2020.

For the allegation, Facility is not in good repair: During staff interviews, 2 out of 3 staff stated that the facility is not in good repair. During resident interviews, 2 out of 3 residents also stated that the facility is not in good repair. During the facility tour, LPA Rico observed that the kitchen stove had missing knobs and the dishwasher did not turn on or off. In addition, LPA Rico observed S2 using a lighter to turn on the stove.

Based on the evidence gathered during today’s investigation, the three (3) allegations listed above are deemed SUBSTANTIATED. A finding of SUBSTANTIATED means the allegations are valid because the preponderance of evidence standard has been met. During today’s visit, three (3) deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) and LIC9099D were discussed with and provided to staff Valerie Rutherford, along with a copy of the appeal rights.