Complaint Investigation Report

336425030-8-28-2024-18-AS-KCLS-D8M6CZ-20240829204223

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

02/07/2020 and conducted by Evaluator Javier Prieto

COMPLAINT CONTROL NUMBER: 18-AS-20200207105543

Facility failed to keep resident adequately hydrated

LPA Javier Prieto and LPA Eldin Serrano arrived at the facility to delivery findings to the listed allegations. LPA met with house manager Angel Sanchez and explained the nature of the visit.

The investigation, conducted by Department staff consisted of interviews with relevant parties, and file reviews revealed that the administrator called 911 due to Resident 1 (R1) having a fast heart rate. R1 was admitted to the hospital on 2/4/2020, and discharged back to the facility on 2/6/2020, on hospice. Hospital documents indicates that R1 was dehydrated.

Based on the LPAs interviews, and review of documents the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. An exit interview was conducted where this report, LIC 9099D, and appeal rights were discussed with and provided to the house manager.