Complaint Investigation Report

347003563-3-4-2022-27-AS-KHOS-CCDHSV-20220310052742

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

12/01/2021 and conducted by Evaluator Bruce Jacobs

COMPLAINT CONTROL NUMBER: 27-AS-20211201111518

Licensing Program Analyst (LPA) Bruce Jacobs arrived at the facility and met with Administrator Grace Bernardino to conclude and deliver investigation findings on the above allegations. This investigation consisted of site inspections to the facility to conduct interviews with the facility administrator, staff, residents and other witnesses. LPA conducted an inspection of the facility and reviewed and obtained copies of the resident's (R-1) files and other documentation.

This investigation concluded after several LPA inspections, interviews and record reviews that there was inadequate evidence to conclude that the home was in disrepair. LPA did observed supplies of PPE in one location of the home, but the home was otherwise uncluttered. LPA met with and spoke to all the residents in the home as well as conducting interviews and reviewing records and there was not evidence to prove neglect of the residents in care.

Based on LPA’s observations and interviews conducted, the preponderance of evidence standard has not been met, therefore the above allegations are determined to be UNSUBSTANTIATED.