Complaint Investigation Report

392700306-3-10-2022-27-AS-KHOS-CCJJUZ-20220315072223

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

01/24/2022 and conducted by Evaluator Bruce Jacobs

COMPLAINT CONTROL NUMBER: 27-AS-20220124141918

Resident is not assisted with their medication in a timely manner

Staff does not provide adequate meal service to residents in care

Staff did not provide laundry services to resident in care

Licensing Program Analyst (LPA) Bruce Jacobs arrived at the facility and met with Facility Administrator Gurpreet Rai to deliver investigation findings on the above allegations. This investigation consisted of site inspections to the facility to conduct interviews with the facility administrator, staff and residents. LPA reviewed and obtained copies of resident placement and medical files.

This investigation concluded after several LPA inspections, interviews and record reviews that the facility is administering medications as prescribed and recording the administration in the Medication Administration Record. LPA reviewed menus, observed several meals and interview the facility cook and kitchen staff. Meals and menus were determined to meet nutritional requirements and of sufficient quality. There was not sufficient information to prove facility staff did not provided services listed on admission agreement(s) including laundry service as required

Based on LPA’s observations and interviews conducted, the preponderance of evidence standard has not been met, therefore the above allegations are determined to be UNSUBSTANTIATED.