Complaint Investigation Report

342700903-2-23-2023-27-AS-KHOS-CPPS8W-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

Licensee did not report to the licensing agency within the agency's next working day and a written report should be submitted to licensing within seven days following the occurrence of such event.

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 Caregiver Stephanie Siewe Ehimamiegho

During the investigation, LPA collected Resident #1’s (R1) physician report, staff notes, incident reports, needs and service plan and admission agreement. LPA also interviewed the administrator and five collaborating agency personnel. Based on Incident reports, Administrator did report prior visits of R1 to the hospital and when R1 was placed on 5150. The visits that occurred on 10/11/22, 12/03/22 and 12/07/22 were reported and submitted to licensing as required.

This agency has investigated the complaint alleging that the licensee did not report incidents to the licensing agency . We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

No deficiencies, Exit Interview Conducted.