Complaint Investigation Report

415601114-12-14-2023-14-AS-KHOS-D2DMCS-20240212082957

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SAN BRUNO RO , 851 TRAEGER AVE., SUITE 360

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

07/25/2023 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20230725115745

- Staff are not following infection control requirements.

On this day Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings regarding the above allegation. LPA met with Business Office Director Ana Gobeleza and explained purpose of today's visit.

During the course of the investigation LPA conducted multiple interviews and reviewed protocols with previous administrator Meghan Leone. LPA discovered that there was not enough COVID test kits on hand during an outbreak in memory care. Additionally, isolation procedures, social distancing, appropriate signs, hand sanitizer, gowns, and masking requirements were not being fully adhered to during the outbreak. Residents were congregating despite of COVID status and there was a lack of PPE being utilized to help mitigate the spread of COVID. This allegation is substantiated.

Based on LPA interviews and items letters received, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, are being cited on the attached LIC9099D.

Report is reviewed with Ana Gobeleza. Appeal rights are provided.