Complaint Investigation Report

342701121-12-29-2022-27-AS-KHOS-CMZPXA-20230112104201

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 2525 NATOMAS PARK DR. STE.270

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

12/21/2022 and conducted by Evaluator Christopher Hopkins-Clarke

COMPLAINT CONTROL NUMBER: 27-AS-20221221091631

-Staff did not seek medical attention for resident in care

On 12/29/22 at 11:11AM, Licensing Program Analyst (LPA) Chris Hopkins conducted an unannounced facility visit in regards to a complaint investigation with the above allegation. LPA Hopkins met with Executive Director Luis Olivas and explained the purpose of today's visit.

Regarding the allegation of Staff did not seek medical attention for resident in care, the Department found the following; based on interview and record review, it was determined that staff were never made aware of Resident 1 (R1) having chest pain. R1's charting notes only indicated there was a shoulder pain in which staff administered a PRN medication for that.

Although the allegations may have happened and/or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted with Executive Director Luis Olivas. A copy of this report was left upon exit.