Complaint Investigation Report

385600432-12-19-2022-14-AS-CSMH-CNNT9A-20230202133133

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SF COASTAL AC/SC , 851 TRAEGER AVE., SUITE 360

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

10/14/2021 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20211014120141

Resident hit another resident while in care

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in delivering the findings on the above allegation. LPA met with licensee/administrator William Encarnacion and exlpained the purpose of today's visit.

During the course of the investigation it was discovered through medical diagnosis, and interviews conducted, that R1 did suffer facial fracture due to trauma to the face. Through interviews conducted with the resident, and medical records reviewed, it was determined that R1 was hit in the face with a closed fist by another resident R2. This allegation is substantiated.

Based on LPA interviews and items letters received, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, are being cited on the attached LIC9099D. Report is reviewed with the licensee William Encarnacion.