Complaint Investigation Report

336426330-2-28-2022-18-AS-RSTS-CXF2VM-20231109164410

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

01/24/2022 and conducted by Evaluator Jesse Gardner

COMPLAINT CONTROL NUMBER: 18-AS-20220124122518

Staff are not allowing hospice staff into facility to provide care to resident

Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced visit to deliver findings on the above allegation. LPA met with Assistant Administrator Raquel Montes. LPA interviewed Resident One (R1), and after record review, and previous interview of Administrator who confirmed that the order was made to not allow R1s new hospice agency to provide services, LPA determined the above complaint was deemed to be SUBSTANTIATED.

A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted, and copies of this report, LIC811, LIC9099-D, and Appeal Rights were discussed with and provided to Ms. Montes.