Complaint Investigation Report

331880652-8-18-2021-18-AS-KCLS-C67L5B-20210824082646

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

09/26/2019 and conducted by Evaluator Jennifer Semin

COMPLAINT CONTROL NUMBER: 18-AS-20190926112814

Facility staff physically abused resident.

Licensing Program Analyst (LPA) Jennifer Semin made an unannounced visit to the facility to deliver the final complaint investigation report. LPA met with Viridiana Cisneros and spoke with Licensee Channe Carlos via telephone. The investigation consisted of interviews with staff, residents and relevant parties. Interviews with residents revealed that although Resident 1 stated staff physically abused them, Residents 2-5 stated they have never been physically abused by any staff nor witnessed any staff physically abusing any resident. Staff 2 and Staff 3 deny physically abusing any residents nor have they witnessed any staff physically abusing any residents. Staff 1 was unable to be interviewed due to three unsuccessful attempts to contact Staff 1. LPA confirmed that Resident 1 did not have a roommate nor were there any witnesses to cooperate the allegation that staff physically abused resident.

Based upon interviews and information gathered, and although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED at this time.

An exit interview was conducted where this report was discussed with Channe Carlos via telephoneand provided to Viridiana Cisneros