Complaint Investigation Report

342700903-2-23-2023-27-AS-KHOS-CPPS8X-20230307123946

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

12/09/2022 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20221209083147

The licensee did not mail or fax to the Department a copy of the 30-day written notice in accordance with (a) above within five days of giving the notice to the client.

At approximately 11:00 am on 02/23/23, Licensing Program Analyst (LPA) Renee Campbell and Licensing Program Manager Liza King, made an unannounced visit to Ehimas to deliver the findings of a complaint investigation. LPA Campbell discussed the purpose of the visit and the elements of the allegation with .

During the investigation, LPA collected Resident #1’s (R1) physician report, staff notes and needs and service plan. LPA also interviewed the administrator and five collaborating agency personnel. Although W1 informed the regional office that the administrator reported that he did not want the resident to return to the facility following R1’s 5150 hold, interviews with four other collaborating agency staff members including mental health, placement and payee service, were unable to corroborate the allegations of W1.

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

No deficiencies, Exit Interview Conducted.