Complaint Investigation Report

486803806-1-17-2023-21-AS-CMAZ-CN7SRF-20230118130615

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

08/29/2022 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20220829163730

VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THE

Facility did not provide adequate supervision resulting in an injury

Facility did not seek timely medical attention

Licensing Program Analyst Leibert arrived unannounced for the purpose of closing this complaint. LPA met with Rammy Kaur and discussed the findings. This Department has investigated the allegations by conducting interviews and obtaining and reviewing documents. Based upon the documents and interviews, the following determinations are made: R1, who is a fall risk, required bathroom assistance and status checks; Care staff were aware of R1's status and checked on R1 at approximately 3:30 am on night of 08/27/2022; approximately 1 hour and 20 minutes later R1 was checked again and found to have fallen to the floor and sustained an injury; Staff immediately called 911 and remained with R1 until paramedics arrived. Although the allegations may be true, based upon the interviews and documents reviewed, there is not a preponderance of evidence to prove the allegations true or, not true. therefore, the allegations are UNSUBSTANTIATED.