Complaint Investigation Report

Based on the staff interviews conducted, review of Dish Machine Temperature Log, and LPAs' observations, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Exit interview conducted. Plan of Corrections reviewed and developed with Administrator. Copy of report, LIC 9099-D, and Appeal Rights discussed and provided to Administrator. Signature on form confirms receipt of documents.