Complaint Investigation Report

430708498-4-3-2024-26-AS-KHOS-D4KJDT-20240422065804

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

07/14/2021 and conducted by Evaluator Grace Donato

COMPLAINT CONTROL NUMBER: 26-AS-20210714143311

On 4/3/2024, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced complaint inspection. LPA met with Administrator Marina Sampani explained the purpose of the visit.

The Department investigated the allegation that facility did not meet resident’s needs and based on interviews with staff from the Day Program, R1 has to come Program on multiple occasions with dried feces in their diaper.

Therefore, based on interviews and information collected, the above allegation is determined to be SUBSTANTIATED. Deficiencies of the California Code of Regulations, Title, 22 cited on the LIC9099-D. Failure to correct the deficiencies may result in civil penalties.

A copy of this report and the Appeal Rights are provided.