Complaint Investigation Report

Peninsula Reflections, Colma09/02/2021Licence 415600976

Census42
Date signed09/02/2021 04:46:01 PM
The inspector’s account

415600976-9-2-2021-14-AS-KHOS-C6MKRW-20210907080838

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 851 TRAEGER AVE., SUITE 360

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

08/23/2021 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20210823084459

Facility staff did not prevent resident from leaving the facility

On this day at 1600hrs, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit to conduct the initial investigation visit and deliver findings for the allegations received. LPA met with administrator Anna Allas and explained purpose of today's visit.

During the course of the investigation LPA conducted interviews and reviewed pertinent resident documents. According to facility staff interviewed, they saw and followed the resident when she left the facilty. They attempted to redirect the resident back to the facility but the local police department was called when she would not return. They stayed with the resident until police arrived. According to the facilty the intent was for the resident to return. Facility requested additional care and medication adjustment but was notified that the resident was going to be relocated by her placement team. Facility insisted the intent was for the return of the resident and not a relocation. LPA did not receive any return calls from complainant regarding the allegations and was unable to conduct interviews with the complainant. These allegations are unsubstatiated.

Based on these observations, the above allegations are UNSUBSTANTIATED.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are unsubstantiated at this time.

Report is discussed and reviewed with administrator.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction