Complaint Investigation Report

LPA interviewed the RP, who reported a visible unknown black substance around the edges of a water bottle. LPA reviewed the evidence and confirmed the presence of the unknown substance. The RP stated that they were confident the bottle had not been properly sanitized by staff. Based on the evidence provided by the RP and interviews conducted, the preponderance of evidence supports that the facility failed to ensure that R1’s drinking container was clean and sanitary.

Based on interviews and evidence reviewed, this allegation is Substantiated . A substantiated finding means the allegation is valid because the preponderance of the evidence standard has been met.

Deficiencies are cited from the California Code of Regulations (CCRs). Failure to correct the cited deficiencies by the Plan of Correction (POC) due date may result in civil penalties.

Exit interview conducted. A copy of the report, LIC 9099D (Deficiency Page), Plan of Correction, and Appeal Rights were discussed and provided to the Administrator. Signature on form confirms receipt of documents.