Complaint Investigation Report

445294156-4-24-2024-26-AS-JJIN-D6KVFP-20240625162417

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

01/05/2021 and conducted by Evaluator Grace Donato

COMPLAINT CONTROL NUMBER: 26-AS-20210105093442

Resident not administered medication as prescribed

On 4/24/2024, Licensing Program Analyst (LPA) Grace Donato conducted an unannounced complaint inspection. LPA met with Executive Director, Momo Duoa and explained the purpose of the visit.

During the visit, LPA conducted a tour of the facility, interior and exterior to ensure there are no potential or immediate health and safety risk at the facility.

On 01/05/2021, the Department received a report alleging that staff not meeting residents care needs and resident not administered medication as prescribed.

The Department conducted interviews and record reviews. Based on the information available, it was unable to prove whether staff were not meeting residents care needs and resident was not administered medication as prescribed.

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 deficiencies were cited during the visit. Report is reviewed and copy is provided.