Complaint Investigation Report

360902129-10-22-2021-18-AS-DMUN-C8JTY3-20211107140803

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

08/12/2021 and conducted by Evaluator Elecia Weathersby

COMPLAINT CONTROL NUMBER: 18-AS-20210812151632

#1 Facility staff will not clean resident's room

#2 Facility is charging resident for a service he does not receive

Licensing Program Analyst's (LPA) Elecia Weathersby made an unannounced visit to the facility for the purpose of investigating complaints regarding the above allegations. LPA met with facility Licensee, Jim Braswell and explained the purpose of the visit. Below is a summary of the findings of the investigation:

Allegation #1: Facility staff will not clean resident's room

LPA was unable to verify by sight, record review or interviews, that resident 1 (R1) or other residents, were not receiving cleaning services. R1 disclosed that R1 declines cleaning services and can clean without assistance from staff.

Allegation #2 Facility is charging resident for a service he does not receive

LPA verified by record review and interviews, that meal service is included in a resident's monthly fee and basic services amount. A residents monthly fee does not change should a resident decline meal services. RP admitted to this LPA that R1 declines all meals service provided by the facility.

Based upon interviews and information gathered, the allegation is UNFOUNDED, meaning that the allegation is false, could not have happened, or is without a reasonable basis.

An exit interview was conducted and a copy of this report and LIC811 was provided to Licensee, Jim Braswell.