Complaint Investigation Report

486803852-10-20-2023-21-AS-KMOA-CWXVMM-20231025163346

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 1450 NEOTOMAS AVENUE, STE. 100

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

09/28/2023 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20230928092636

Licensing Program Analyst Leibert arrives unannounced for the purpose of delivering findings on this complaint. LPA met with care staff and discussed the disposition. It has been alleged that S1 has violated the personal rights of 2 clients in care by making derogatory statements and directing expletives to them along with unwanted physical contact. S1 denies the allegations. Both clients have made consistent statements about the allegations and a staff/witness has confirmed being told similar reports from the clients. Facility Management has taken corrective measures with S1 in response to their own investigation. Based upon the statements made, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.