Complaint Investigation Report

331881395-6-8-2023-18-AS-JESL-CT2VJJ-20230622162850

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

05/31/2023 and conducted by Evaluator Javina George

COMPLAINT CONTROL NUMBER: 18-AS-20230531150052

Facility is not following residents health care directive.

Resident is not being afforded privacy with phone calls and visits.

Licesning Program Analyst(LPA) made an unannounced visit to the facility to commence a complaint investigation in regards to the allegation(s) listed above. LPA was greeted and granted entry by the Licensee Ursula Carlos, where explained the purpose of the visit and the elements of the allegation(s). Mrs. Carlos stated that the facility does not have Resident #1 (R1) residing at the facility, as they are at the sister facility.

In addition, LPA was provided a copy of the resident roster, and did not see R1 on the list. Based on observation, interviews and record review all three (3) allegations Lack of care and supervision, facility is not following residents health care directive, and resident is not being afforded privacy with phone calls and visits are UNFOUNDED. A finding that the complaint is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Therefore, the department had there dismissed the complaint.

An exit interview was conducted and a copy of this report was provided to Rommel and Ursula Carlos.