Complaint Investigation Report

392790073-9-8-2021-27-AS-KHOS-C6VKQ4-20210915080545

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

08/19/2021 and conducted by Evaluator Bruce Jacobs

COMPLAINT CONTROL NUMBER: 27-AS-20210819092412

Resident's car insurance was cancelled without resident's (C-1) consent.

LPA Bruce Jacobs conducted an unannounced complaint visit at the facility and met with Aryana Rhood and spoke to Administrator Kenneth Martin by phone to discuss and complete this complaint investigation. LPA provided findings regarding the allegations listed above. The investigation was conducted by LPA Jacobs and consisted of reviews of the facility records and interviews with facility management and staff. The residents and other witnesses were contacted and interviewed.

The complaint allegation listed above was investigated. The resident, facility staff and management and other witnesses were interviewed by LPA Jacobs on 08/20/21. The resident and Facility Administrator stated that the insurance was cancelled by mutual agreement. Other witnesses interviewed provided conflicting information on the allegation. Based on LPA’s observations and interviews conducted, the preponderance of evidence standard has not been met, therefore the above allegation is determined to be UNSUBSTANTIATED.

A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations occurred

Exit interview conducted, report provided to the Aryanna Rhodd.