Complaint Investigation Report

486803946-7-16-2024-21-AS-KMOA-D8BP82-20240820110446

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

05/29/2024 and conducted by Evaluator Araceli Canela

COMPLAINT CONTROL NUMBER: 21-AS-20240529102118

Failure to seek timely medical resulting in death

Licensing Program Analyst (LPA) Araceli Canela arrived at this facility unannounced, to deliver findings regarding the above allegation. LPA met with both licensees, Cecilia Ganzon & Aurelia Renta.

It was alleged facility failed to seek timely medical resulting in death of a resident. LPA requested & received records; including Community Care Licensing (CCL) Investigations Branch report.

Investigation included review of Vallejo Police Department report #24-5069, in which there was no indication of foul play and R1's death was due to natural causes. The Medic Ambulance Patient Care Report indicated R1 had a DO Not Resuscitate (DNR) form in file. Per R1's Certificate of death, R1's cause of death was noted as Dementia with Lewy Bodies with onset notes as years. There was no indication that facility staff failed to seek timely medical attention resulting in death.

Based on the information gathered, the above complaint allegation is UNFOUNDED, meaning that the allegations were false, could not have happened and/or is without a reasonable basis.