Complaint Investigation Report

374604304-10-20-2022-08-AS-LTEZ-CKQSQ4-20221031140408

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 7575 METROPOLITAN DR. #109

This is an official report of an unannounced visit/investigation of a complaint received in our office on

10/11/2022 and conducted by Evaluator Sabel Martinez

COMPLAINT CONTROL NUMBER: 08-AS-20221011075637

Facility staff did not treat resident with dignity

Facility staff forced resident to take medications

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced visit to initiate a complaint investigation regarding the above allegations. The LPA was greeted by Caregiver, Christine Telo, identified himself, and disclosed the purpose of the visit.

During the visit, the LPA conducted a tour of the facility, reviewed pertinent records and interviewed staff. Based upon a review of records and interviews conducted, it was determined Resident # 1 (R1) had not resided at the facility, thus, finding the complaint allegations to be unfounded. This means the allegations were false, could not have happened, and/or were without a reasonable basis. The facility is in compliance with Title 22 regulations at this time, and no deficiencies were cited on today's date

An exit interview was conducted with Caregiver, Christine Telo. A copy of this report and Licensee Rights (LIC 9058) were provided to the Administrator, Rafael Gamab, via electronic mail. An electronic mail read receipt confirms the documents were received by the administrator.