Complaint Investigation Report

331881330-7-28-2022-18-AS-DMUN-CHVS65-20220902133521

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

07/21/2022 and conducted by Evaluator Chinwe Nwogene

COMPLAINT CONTROL NUMBER: 18-AS-20220721115216

Arnold Bravo and Venus Bravo, Facility Operators

Licensing Program Analyst (LPAs), Chinwe Nwogene and Crystal Colvin, conducted an unannounced visit to the home to initiate the investigation into the above allegation. LPAs met with facility operators Arnold Bravo and Venus Bravo, and informed them of the purpose of the visit.

Regarding the allegation, “Unlicensed care being provided”, it was alleged there were residents in the home who required elements of care and supervision. LPAs initiated the investigation on the date 7/28/2022. LPAs Interviewed Facility operators and residents, residents’ files and records were reviewed, and copies of pertinent documents were obtained. Interviews and record review revealed the five (#5) residents receives assistance with their activities of daily living. It was reported all five (#5) residents receive assistance with toileting and assistance with dressing. In addition, it was reported all five (#5) residents are dependent on the facilty operators to prepare meals for them. LPAs observed Resident #2 (R2)being fed by operator in bed.

Therefore, based upon the investigation this allegation is substantiated. California Code of Regulations (Title 22, Division 6) are being cited on the attached LIC 9099D). An exit interview was conducted, and a copy of this report was reviewed and provided along with appeal rights to Venus Bravo.