Complaint Investigation Report

486803806-10-10-2024-21-AS-KMOA-DA5L2N-20241017082237

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

09/18/2024 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20240918175043

VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THE

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. Complainant has alleged that facility has refused the return of R1 to the facility following a hospitalization due to a prohibited condition that would preclude R1's residency in the facility. R1 has a CVC catheter. During the course of this investigation statements were taken, documents reviewed and a consult occurred with a Program Clinical Consultant. Based upon the statements, documents and consult, the following determinations are made: The type of CVC catheter (Perm-Cath) used by R1 is not a prohibited condition that would preclude R1's residency in the facility; R1 was illegally evicted by the facility when R1 was not allowed to return. Based upon these determinations, statements, and documents, 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.