Complaint Investigation Report

331881324-12-15-2022-18-AS-DMUN-CMHVXF-20221227154927

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

12/12/2022 and conducted by Evaluator Tricia Danielson

COMPLAINT CONTROL NUMBER: 18-AS-20221212160952

EXECUTIVE RESIDENTIAL CARE & RECOVERY LLC

Facility did not notify licensing of facility alterations

Licensing Program Analyst(LPA) Tricia Danielson arrived unannounced to the facility to initiate an investigation into the allegation listed above. LPA met with Program Manager Andrew Whynaught and explained the purpose of today's visit. There were no residents present in the facility during today's visit.

During today's visit, LPA toured the facility and interviewed one(1) staff. Regarding the allegation "Facility did not notify licensing of facility alterations", it was alleged that the facility did not notify Community Care Licensing(CCL) of property damage suffered from a water heater leak and the damaged areas required repair. CCL records reviewed revealed no notification was provided as required and a tour of the facility revealed several rooms taped of with plastic during the construction. LPA also observed a worker preparing a shower area for repair with hot tar. The rooms taped off were observed to be very dusty from the sanding of newly repaired drywall and/or baseboards. Interview with Program Manager Whynaught indicated baseboards and tile damaged by the water leak were being repaired. Based on LPA’s observations, interview which was conducted and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099 D. A copy of list report and appeal rights was provided.