Complaint Investigation Report
405801337-3-25-2022-29-AS-KBUY-CDAQS9-20220408122509
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
03/23/2022 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20220323135925
Staff member was not wearing a mask at the facility.
Licensing Program Anaylst (LPA) De Leon conducted a 10-day Complaint visit to the facility above. LPA met with Administrator Cheryl Cradduck and explained the purpose of the visit.
LPA Requested a Staff Roster and Resident Roster. LPA interviewed Staff 1 (S1).
On the allegation: Staff member was not wearing a mask at the facility. LPA interviewed crediable witness (W1) which revealed that W1 visited the facility on 03/23/2022 and upon entry to the facility S1 was sitting at the dining room table with two residents and was not wearing a mask. S1's interview revealed S1 was not wearing a mask on that visit. Based on the evidence the allegation is deemed Substantiated at this time.
Exit interview conducted, deficiency cited, copy of report and appeal rights emailed to Licensee/Administrator.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction