Complaint Investigation Report

361880525-5-20-2022-56-AS-KCLS-CM5SJ2-20221215125423

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1650 SPRUCE ST STE 200 MS29-27

This is an official report of an unannounced visit/investigation of a complaint received in our office on

05/18/2022 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 56-AS-20220518164927

Licensee refused to allow resident to return to the facily after discharge from the hospital.

Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to the facility to investigate the above allegation. LPA met with licensee David Tamo Administrator.

Based on interview and observations of documents the administrator David Tamo confirmed that (R1) has not been allowed to return to the facility unless 24hr care could be provided upon (R1) return to assist with his higher level of care.

Based on LPA's observations, interviews, and record reviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 & Chapter 8), is being cited on the attached LIC9099D. An exit interview was conducted where this report, LIC9099D and appeal rights were provided to Administrator David Tamo.