Complaint Investigation Report

331881421-3-7-2023-18-AS-JESL-CQCVMC-20230328163316

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

02/27/2023 and conducted by Evaluator Tricia Danielson

COMPLAINT CONTROL NUMBER: 18-AS-20230227095711

Licensing Program Analysts (LPAs) Tricia Danielson and Jesse Gardner arrived unannounced to initiate an investigation into the allegation listed above. LPAs met with Administrator Ma Satchel Lecita and explained the purpose of the visit. This home currently has eight (8) residents residing here.

LPAs interviewed eight (8) residents. Five (5) of eight (8) residents do not require care and supervision and are independent on all activities of daily living (ADLs). Three (3) of eight (8) (R2, R5, R8) are receiving hospice services from outside agencies for assistance with ADLs. LPAs verified hospice services with the agencies for all three (3) residents. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted and a copy of this report was provided along with LIC811- Confidential Names list.