Complaint Investigation Report

331800156-1-13-2022-18-AS-CTUA-DRPRFW-20260227115947

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

01/03/2022 and conducted by Evaluator Yolanda Delgado

COMPLAINT CONTROL NUMBER: 18-AS-20220103091332

Resident not allowed to return to facility due to illness

Resident's authorizied person was denied a copy of the Admission Agreement.

Licensing Program Analyst (LPA) Yolanda Delgado arrived to the facility to conclude a complaint investigation into the allegations noted above. LPA met with House Manager Cedric Williams. House Manager contacted Administrator via telephone and LPA discussed the reason for the visit.

The investigation revealed that R1 was returned to the facility on January 3, 2022 at 2:00pm and the facility had R1 quarantined. R1's authorized person will be given a copy of the Admission agreement, it needs to be picked up. Rent was paid by check on January 3, 2022 to the facility. The issue has been resolved between both parties.

The above allegation is found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time. There were no deficiencies and no civil penalties that were cited per Title 22, Division 6, of the California Code or Regulations.

An exit interview was conducted with House Manager and a copy of this report was provided.

Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.