Complaint Investigation Report

415600874-8-16-2022-14-AS-KHOS-CHTJMU-20220831071056

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

08/12/2022 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20220812113819

Facility did not submit an incident report to licensing

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit. LPA met with administrator Monica Ceron Tapia. LPA explianed the purpose of the visit.

During the course of the investigation LPA reviewed the incident report regarding a situation that took place on 8/2/2022. The incident was reported to the Department within the specified time frame required for reporting such incidents. The Department has copies of these incident reports. This allegation is unfounded.

This agency has investigated the complaint alleging that the facility did not submit an incident report to licensing . 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.

No citations issued. Report is reviewed with administrator.