Complaint Investigation Report

342700133-12-20-2022-27-AS-KHOS-CMLSQP-20221230130504

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

12/13/2022 and conducted by Evaluator Christina Valerio

COMPLAINT CONTROL NUMBER: 27-AS-20221213145103

Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannouced to conduct a 10-Day Complaint Investigation and deliver complaint findings. LPA met with Administrator Debbie Loesch, and explained the purpose of the visit.

Administrator Debbie Loesch self reported an incident to the regional office on 12/12/2022. On 12/12/22, a staff member, Staff 1 (S1), made physical contact with a resident, Resident 1 (R1). S1 was assisting R1 in the shower. R1 bit down on S1's upper arm. S1 reacted by slapping R1 in the head with hand. The assistant administrator immediately removed the S1 from the shower was suspended. Police and family were contacted. R1 has a dx of dementia and could not remember what happened when asked by police and/or staff. Administrator gave voicemail of S1 admitting to the incident, a written report from staff, and case number for Elk Grove Police Department.

Per California Code of Regulations, Title 22, deficiences are being cited on LIC 9099-D. Failure to correct deficiences may result in civil penalities. An exit interview was held, and a copy of the report was provided.