Complaint Investigation Report

455002675-6-16-2022-25-AS-MSEY-CFLSVC-20220621141232

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 520 COHASSET RD., STE. 170

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

06/15/2022 and conducted by Evaluator Misty Valencia

COMPLAINT CONTROL NUMBER: 25-AS-20220615092327

Authorized Representative was not reimbursed after resident's death.

Licensing Program Analyst (LPA) Misty Valencia conducted an unannounced complaint investigation visit regarding the above allegation directed by the department. LPA met with Facility Manager Audra Enieix and explained the reason for the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted Administrator and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical mask. Additionally, LPA was screened by staff at the front door

The LPA received a report stating that the Authorized Representative did not receive a refund after a residents death. However, the LPA received confirmation and documentation that a check was sent to the address on file on 06/15/2022. The LPA finds this allegation to be UNFOUNDED - meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Exit interview conducted and copy of this report was emailed to Admin.