Complaint Investigation Report

415601046-9-27-2022-14-AS-KHOS-CKHLP2-20221024085513

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SF COASTAL AC/SC , 851 TRAEGER AVE., SUITE 360

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

09/19/2022 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20220919164139

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit to open and deliver findings regarding the allegation received. LPA met with Jovy Castro and explained purpose of today's visit.

During the course of this investigation LPA received multiple email communications from the administrator Karen Nickolai dating back to May 2022 up until September 2022 appraising LPA regarding the situation with R1. LPA reviewed the documentation received during these communications, including the arrangement of a family member to meet with R1 at the specific hospital, and the family member did not meet R1. This allegation is unfounded.

This agency has investigated the complaint alleging that the facility a resident. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint. Report is discussed with Jovy. No citations issued.