Complaint Investigation Report

415601048-3-13-2023-14-AS-CSMH-CPZN95-20230317101520

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

01/26/2023 and conducted by Evaluator Jaime Vado

COMPLAINT CONTROL NUMBER: 14-AS-20230126160552

- Resident was injured by staff while in care

On this day, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit in order to deliver findings in regards to the investigation on the allegation received. LPA met with the licensee Juliet Pacaldo and explained the purpose of today's visit.

During the investigation LPA conducted multiple interviews and reviewed pertinent documents. Interviews completed resulted in identifying two incidents, which were logged and reported, where a resident could have been injured. LPA could not prove that the resident was injured by staff intentionally. Both incidents discuss the nature of injuries sustained as being accidental where staff were in place and trying to assist the resident. LPA could not prove or disprove this allegation took place.

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. No citations issued. Report is reveiwed with Juliet.