Complaint Investigation Report

415601114-12-14-2023-14-AS-KHOS-CZ4QUH-20240102112846

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

09/19/2023 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20230919091925

- Staff did not assist resident to and from restroom

On this day, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings regarding the allegation received. LPA met with business office director Ana Gobaleza and explained the purpose of today's visit.

During the course of the investigation, LPA conducted interviews, made facility observations, and reviewed documents. Per interviews with staff, they did not witness the situation described per details received. Staff recall being present but did not see the situation. Staff indicated that the resident did not ask for assistance. The location of the bathroom where this took place was not in sight of the staff who was providing an activity with other residents in the memory care's living room area. The bathroom is around the corner out of the line of sight from the nearest staff person at the time this took place. The resident's room is also located across the hall from where the bathroom is. The resident does require assistance to the bathroom but according to staff they were not alerted to assist the resident to the restroom, but instead the resident went to the restsroom on their own without assistance being called for. This allegation is unsubstantiated.

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.