Complaint Investigation Report

347005464-7-28-2022-27-AS-SRIN-CJQU39-20220929151311

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

05/11/2022 and conducted by Evaluator Victoria Brown

COMPLAINT CONTROL NUMBER: 27-AS-20220511123036

Lack of supervision resulting in resident wandering from the facility.

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conclude the investigation of the above mentioned allegation on 7/28/22 at 3:15pm. LPA met with Administrator Jennell Revera and stated the purpose of the visit. LPA conducted an investigation regarding this allegation on a previous Case Management visit dated 4/28/22. Interviews were conducted of Staff (S1-S5) as well on 4/28/22. The facility was cited deficiencies.

Upon a further review of interviews and documentation, the investigation revealed that the deficiencies were to be dismissed due to lack of evidence. The preponderance of evidence standards has not been met; therefore, the above allegation(s) is found to be UNSUBSTANTIATED.

A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited. An exit interview was conducted, and a copy of this report was provided.