Complaint Investigation Report

486803612-7-20-2023-21-AS-KMOA-CUJURZ-20230809154933

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SANTA ROSA RO , 1450 NEOTOMAS AVENUE, STE. 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

07/17/2023 and conducted by Evaluator Carol Fowler

COMPLAINT CONTROL NUMBER: 21-AS-20230717165033

Licensing Program Analyst Carol Fowler arrived to open a complaint investigation. LPA interviewed RP and Administrator.

During visit LPA interviewed Administrator via phone. The allegation that R1 was unlawfully evicted was corroborated in an interview with the Administrator, who confirmed that R1 was taken to the hospital by family and the Administrator refused to accept R1 back to the facility due to health issues, safety of residents and staff and felt R1needed a higher level of care. This poses a potential personal rights risk to the resident in care.

As a result of the investigation, the allegation Unlawful eviction is substantiated.

Deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties.