Complaint Investigation Report

336427578-11-1-2021-18-AS-JESL-C98S27-20211129122902

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

10/26/2021 and conducted by Evaluator David Cuevas

COMPLAINT CONTROL NUMBER: 18-AS-20211026145339

Licensing Program Analyst (LPA) David Cuevas conducted an unannounced visit to the facility to initiate an investigation to allegation above. LPA met with caregiver, Ms. Manuel who was informed of the purpose of visit. Ms. Manuel called Administrator, Julita Mendoza who arrived at the facility shortly after.

During this investigation LPA conducted records review, direct observations, and interviews with staff and residents.

Regarding allegation: Staff yells at a resident while in care

During visit LPA interviewed a total of (5) individuals’ available, staff and residents. Per collected interviews 5 out of 5 interviewees communicated to have no knowledge of or witnessing staff yelling at Resident # 1 (R1) while in care. Furthermore, all resident in care expressed being content with placement and to have not witness any staff yelling at any resident. Additionally, interviews with Staff # 1(S1) and staff # 2 (S2) deny any occurrence in which staff yelled at R1 or any other resident in care at facility, as such based on interviews and collected evidence, the allegation of Staff yells at a resident in care is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without reasonable basis.

An exit interview was conducted where a copy of this report was discussed and provided to Administrator, Julita Mendoza.