Senior Care Records.

Complaint Investigation Report

Pennsylvania Care Home, Fairfield06/28/2024Licence 486800768

Census4
Date signed06/28/2024 02:13:49 PM
The inspector’s account

486800768-6-28-2024-21-AS-BMOS-D7PUQY-20240731154756

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SANTA ROSA RO , 1450 NEOTOMAS AVENUE, STE. 100

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

05/24/2024 and conducted by Evaluator Julie Florio

COMPLAINT CONTROL NUMBER: 21-AS-20240524090931

Personal Rights/ Staff do not treat resident with dignity and respect

Licensing Program Analyst (LPA) Julie Florio arrived unannounced at this facility to obtain additional documents, make observations, complete additional interviews, and deliver findings of above allegation. LPA met with Patricia Bucal, House Manager. LPA conducted 10-day on 5/31/2024 and obtained documents, made observations, and conducted interviews with House Manager, client (C1), and staff (S1).

Today, based on record review, interviews conducted, and observations made, the allegation of Personal Rights/Staff do not treat resident with dignity and respect is UNSUBSTANTIATED, meaning that although the allegation 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 allegation is UNSUBSTANTIATED..

Exit interview conducted. Copy of report discussed and provided to House Manager. Signature on form confirms receipt of documents.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction