Complaint Investigation Report

361800232-1-5-2023-56-AS-NBRN-CNNVST-20230202154202

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

12/30/2022 and conducted by Evaluator Amy Goldenberg

COMPLAINT CONTROL NUMBER: 56-AS-20221230103806

Individual working at facility without criminal record clearance

This unannounced visit by Amy Goldenberg, Licensing Program Analyst (LPA), to initiate the 10 day visit to investigate the above-mentioned complaint allegation. LPA met at the door by Caregiver Gerren Thomas. LPA spoke with Licensee via telephone and disclosed the nature of the allegations. During this investigation LPA interviewed staff, and one (1) of three (3) residents present during this initial visit. LPA additionally received photographs of the staff schedule and resident roster. LPA reviewed Guardian search results. Review of the search revealed that Caregiver Gerren Thomas's criminal record status is pending and is working in this facility without proper clearance. We have substantiated the complaint allegation as valid and that a violation has occurred based on the preponderance of available evidence. A copy of this report along with appeal rights are being reviewed with, and furnished to the facility representative. Please see LIC 9099D.