Complaint Investigation Report

486803614-1-21-2025-21-AS-BMOS-DDDUJD-20250129143723

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

10/04/2024 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20241004094644

Staff not properly trained to provide care to residents.

At approximately 10:00AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an investigation into the above allegation. LPA met with Facility Manager Theresa Ilagan, toured the facility and reviewed documents. LPA spoke with Administrator Rose Mahawar via telephone during this visit. Based on records reviewed, Facility did not have documentation of 5 of 8 staff required training hours completed. LPA discussed the requirements for staff training hours with Administrator and provided a copy of regulation. All staff have received their training since the last visit.

Based on the Departments investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

This report was reviewed with House manager and Appeal rights were given.