Complaint Investigation Report

360902129-3-21-2024-56-AS-KCLS-D3SN7K-20240328101251

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SAN BERNARDINO , 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

03/14/2024 and conducted by Evaluator Magda Malcore

COMPLAINT CONTROL NUMBER: 56-AS-20240314112044

Staff did not provide filtered water to drink to a resident per Admission Agreement

Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced complaint visit to the facility. LPA met with Melanie Niez, Administrator, and discussed the purpose of the visit.

Regarding the allegation, staff did not provided filtered water to drink to a resident per Admission Agreement. LPA review of resident #1 (R1's) admission's agreement reveals no documentation of an agreement to provide filtered water.

Based on interviews and record review, the above allegation is Unfounded. An Unfounded finding means, the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted where this report was discussed and a copy of this report was provided to the Administrator at the conclusion of the visit.