Complaint Investigation Report

374601420-9-21-2022-18-AS-DMUN-CJHVB5-20220922161657

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

09/16/2022 and conducted by Evaluator Tricia Danielson

COMPLAINT CONTROL NUMBER: 18-AS-20220916111931

Staff did not get medical attention timely for resident

Staff are not following Physician's orders

Staff did not tell authorized representative of change in resident's condition

Licensing Program Analyst (LPA) Tricia Danielson arrived unannounced to the facility to initiate an investigation into the allegations list above. LPA met with Administrator Maria Richley and explained the purpose of today's visit.

The allegations of this complaint concern Resident #1 (R1). During today's visit, it was discovered that R1 does not reside at this facility but rather, resides at a facility two houses away with a very similiar address.

Therefore, the allegations list above are UNFOUNDED. This agency has investigated the complaint alleging "Staff did not get medical attention timely for resident", "Staff are not following Physician's orders", and "Staff did not tell authorized respresentative of change in resident's condition". We have found that the complaint was unfounded, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

An exit interview was conducted and a copy of this report was provided along with LIC811- Confidential Names List.