Complaint Investigation Report

486803511-6-3-2025-21-AS-KMOA-DHDRLB-20250606130648

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

02/28/2025 and conducted by Evaluator Jill Nakagawa

COMPLAINT CONTROL NUMBER: 21-AS-20250228165924

Staff are not assisting resident after they fall, leaving them for long periods of time

Staff are not meeting resident's care needs

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced on 06/03/2025 to deliver findings of the complaint investigation regarding the above allegations. LPA Nakagawa requested records, conducted interviews and made observations. LPA met with Administrator Al Balbuena and discussed the findings.

The complaint alleges that Staff are not assisting resident after they fall, leaving them for long periods of time. LPA conducted interviews with resident R1 who was unable to recall specific dates and times of incidents where staff left them for long periods of time. LPA inspected staffing records and found staff present at all times. Other residents stated that staff are responsive to their needs in a timely manner and reported the observation of staff helping R1.