Complaint Investigation Report

405802287-4-30-2024-29-AS-KBUY-D5PPVT-20240528113940

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 21731 VENTURA BLVD. #250

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

04/22/2024 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20240422232239

Staff do not properly maintain the facility's electrical outlets

Licensing Program Analyst's (LPA's) De Leon and Rankin conducted a 10-day complaint visit to the facility above. LPA was greeted by care staff and called Administrator. Administrator is at a pre-scheduled appointment and can not met LPA for visit. Administrator will have care staff sign report.

LPA requested a staff roster with telephone numbers and a current resident roster. Administrator will email records to LPA later this afternoon.

LPA's took a physical plant tour of the inside of the facility at 10:25am. LPA's checked several outlets through out the facility and took photographs. Twenty-nine outlets had issues with the cords fitting loosely and the plugs falling out because the contact points start to wear down, Two outlets had the top plug in not working properly, and several outlets had missing or broken covers. Based on LPA's observation and photographs taken the facility this allegation is Substantiated at this time.

Exit interview conducted, deficiency cited, copy of report and appeal right printed for care staff.