Complaint Investigation Report

342701174-5-18-2023-27-AS-KHOS-CSCHQM-20230531062409

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

04/24/2023 and conducted by Evaluator Tung Truong

COMPLAINT CONTROL NUMBER: 27-AS-20230424112522

On 5/18/2023, Licensing Program Analyst (LPA) Tung Truong conducted an unannounced visit to this facility to deliver the complaint findings. LPA met with Administrator Unaisi Waqalala and explained the purpose of the visit.

Throughout the course of the investigation, LPA conducted interviews and reviewed records. Regarding the allegation that staff hit resident, it was learned that facility staff (S1) did not hit resident (R1). Based on staff interview, S1 denied hitting R1 and stated that it was R1 that hit him. Moreover, resident (R4) who witnessed the incident corroborated that it was R1 that hit the staff.

Based on information gathered, LPA finds the allegation above to be UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted, and a copy of this report was left at the facility.