Complaint Investigation Report

405809547-5-20-2022-29-AS-KBUY-CGCUWX-20220715155729

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

05/17/2022 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20220517083341

Staff is not following COVID-19 guidelines.

Licensing Program Analyst (LPA) De Leon conducted a 10-day Complaint visit to the facility. LPA met with Tracy Flaherty Administrator and explained the purpose of the visit.

On the allegation: Staff is not following COVID-19 guidelines. LPA De Leon recieved a statement that Witness 1 (W1) visited the facility on the evening of 5/13/2022 around 5:00 PM, W1 observed a staff (S1) whom appeared to be serving food not wearing mask correctly. The mask was below S1's chin. S2 stated W1 informed S2 and S2 did engage with S1 infroming S1 that it is necessary to wear mask correctly at all times. S2 stated S1 had a mask and was not sure if S1 was wearing it properly or not at the time. S2 stated they explained to staff it is required and staff will be wrote up for non-compliance. Based on the evidence this allegation is deemed Substantiated at the time.

Exit interview conducted, deficiency cited, copy of report and appeal rights given.