Complaint Investigation Report

415600787-10-31-2023-14-AS-KHOS-CY2KXB-20231129071716

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

02/27/2023 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20230227163514

- Resident sustained multiple falls while in care

- Insufficient staffing during the evening hours for the residents

On this day, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings regarding the allegations received. LPA met with resident services director Nora Saavedra and explained the purpose of today's visit.

During the investigation LPA conducted interviews and reviewed documents regarding R1. Incident reports are received documenting the falls. The facility does not have one on one care unless the responsible party agrees to pay for that additional care from an outside agency. This was not initiated by the responsible parties. The facility attempted to work with the family in order to increase supervision but the falls kept occurring naturally. Night staffing in place according to staffing schedule received. These allegations are 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. Report is reviewed with Nora. A copy is provided on this day.