Senior Care Records.

Complaint Investigation Report

Caroline Street, Adelanto07/10/2023Licence 361880596

Census4
Date signed08/02/2023 01:07:46 PM
The inspector’s account

Allegation #2 “Resident sustained injuries due to lack of supervision”. The allegation alleged that a neighbor assaulted R1 for trespassing on their property. LPA Nickolas’ interview with S1 revealed that S1 confirms that a neighbor assaulted R1 for trespassing on their property. LPA Nickolas’ attempted to interview R1; however, R1 could not participate in the interview process. LPA Nickolas’ also interviewed two (2) other residents in care; however, they did not witness the incident.

Based on the evidence gathered during the investigation, the above allegation is substantiated. A finding that the complaint is substantiated means that the allegation(s) is valid because the preponderance of the evidence standard has been met. An immediate Civil Penalty of $1,000 is being assessed for the repeat violation of the California Code of Regulation (CCR), Section 80065(a).

LPA Nickolas' completed an exit interview was conducted, where copies of this report (LIC 9099), LIC 9099D, LIC 421IM, and appeal rights were discussed and provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction