Complaint Investigation Report

392700993-8-10-2022-27-AS-CACL-CHBS4Q-20220815133307

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 2525 NATOMAS PARK DR. STE.270

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

08/09/2022 and conducted by Evaluator Avelina Martinez

COMPLAINT CONTROL NUMBER: 27-AS-20220809162235

On 08-10-2022 at 9:30 am, Licensing Program Analyst (LPA) Avelina Martinez conducted an unannounced facility visit in regards to a complaint investigation with the above allegation. LPA Martinez met with Anuradha Saini and explained the purpose of today's visit.

During this investigation, LPA Martinez conducted interviews and observed resident rooms. Resident 1's (R1) had dead flies on the floor and window sill, which were removed by facility staff. In addition, R1's room had food debris on the floor. I R1's closet rails had dirt build up and dirt on the closet floor. Also, resident 2's closet rails had dirt build up and dirt on the closet floor, which their blankets were placed on the closet floor next to dirt. As a result of this investigation, the Department finds this allegation to be Substantiated. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiency cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted, and a copy of the 9099 report, LIC 9099-D, and appeal rights were given to the facility.