Complaint Investigation Report

486803810-10-30-2023-21-AS-KMOA-CXLMTY-20231115085415

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

10/19/2023 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20231019125734

Residents needs are not being met by facility

Licensing Program Analyst Leibert arrives unannounced for the purpose of delivering findings on this complaint. This investigation included site visits to the facility; statements taken from witnesses and parties; as well as review of documents obtained during the course of the investigation. It has been alleged that the facility has not met R1's needs in that R1 has missed medical appointments; has not set up R1's voice mail; and does not wear a durable medical device prescribed following surgery because staff do not assist R1. The following determinations are made: R1 lives relatively independently with occasional transportation provided by the facility and has not contracted with the facility for additional care; R1's care plan and physician's assessment indicate R1 does not need assistance with activities of daily living; R1's states that R1 has chosen to not attend appointments or wear the medical device on occasions in the recent past. Although the allegation may be true, based on statements and documents reviewed, there is not a preponderance of evidence to prove the allegation is or, is not, true. Therefore, the allegation is UNSUBSTANTIATED.