Complaint Investigation Report

397001473-2-23-2022-27-AS-KHOS-CC4PZQ-20220301104555

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

12/23/2021 and conducted by Evaluator Albert Johnson

COMPLAINT CONTROL NUMBER: 27-AS-20211223161606

Facility does not have an adequate supply of food

Menu posted in the facility is not being followed

Staff is not following precautions to prevent the spread of illness

**This report was amended to add citations which are attached on the 9099D.

Based on records reviewed and interviews conducted the facilty did not have an adequate supply of food. During inspection visits on multiple days and LPA's observation it appears that the food supply is insufficient and does not meet the scheduled menu items. Parties observed a posted menu that was not being followed and sustitutions were not being noted. Also observed were the supply of food in the home that did not meet the 2-day supply of fresh foods requirement. The facility had many containers in the refrigerator and freezer that could not be identified and staff stated they all contained food that belonged to staff. The facility staff showed an additional refrigerator that contained mostly staff food. The facility did not have snacks available for residents (including fresh fruits or foods that could be eaten without being cooked). The pantry with dry goods was locked with a padlock and was removed by staff upon request and remains unlocked.