Complaint Investigation Report

374604117-2-2-2024-18-AS-RSTS-D2F2CJ-20240213161649

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

04/11/2023 and conducted by Evaluator Chinwe Nwogene

COMPLAINT CONTROL NUMBER: 18-AS-20230411130033

Resident wandered from the facility on more than one occasion without adequate supervision.

On April 14, 2023, Licensing Program Analyst (LPA) Chinwe Nwogene conducted an unannounced visit to investigate the above allegation. LPA met with Administrator, Val Paraiso who was informed of the purpose of the visit. At the time of visit, LPA Interviewed staff, reviewed resident’s file, and conducted an inspection of the facility.

Regarding the allegation “Resident wandered from the facility on more than one occasion without adequate supervision”, LPA interviewed staff who acknowledged that resident has wandered off of the facility twice but was found and was redirected back to the facility. Administrator stated staff was unaware when resident wandered off. Resident file review revealed resident has cogitative disorder. File review further revealed resident had no care plan or documentation on how to address the needs of resident. LPA inspected facility and observed facility has no safety measures in place to address wandering behaviors.

Based on LPA’s interviews, record review and facility inspection, the above allegation is found to be substantiated. California Code of Regulations (Title 22, Division & Chapter number 6 is being cited on the attached LIC 9099D). An exit interview was conducted, and a copy of this report was reviewed with and provided along with appeal rights to Val Paraiso.