Complaint Investigation Report

347002709-4-27-2022-25-AS-LMUZ-C8SPAY-20211115100928

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 520 COHASSET RD., STE. 170

This is an official report of an unannounced visit/investigation of a complaint received in our office on

10/12/2021 and conducted by Evaluator Jacob Williams

COMPLAINT CONTROL NUMBER: 25-AS-20211012113058

Licensee does not properly supervise residents

Uncleared adults residing in the facility

Licensing Program Analyst (LPA) Williams conducted this complaint visit with Aurica Pop, in order to close out the above allegation. Prior to initiating this visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured he applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask.

During the inspection, LPA investigated the allegations "Licensee does not properly supervise residents". LPA toured the facility and interviewed three out of the four tenants. It is determined that there are no RCFE clients living in the facility; there are only tenants renting as a part of a room and board. None of the four residents are receiving any care or supervision. The allegation of Uncleared adults residing in the facility was deemed unfounded as there were no current residents residing in the home.

Based upon the information obtained during investigation, the above allegations are unfounded. A finding that the complaint is unfounded means that the allegation was false, could not have happened and/or is without a reasonable basis. Copy of this report provided.