Complaint Investigation Report

496804017-3-23-2023-21-AS-KMOA-CQ7VZE-20230323165236

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

12/19/2022 and conducted by Evaluator Erik Gonzalez Campos

COMPLAINT CONTROL NUMBER: 21-AS-20221219120741

Staff interferes with resident visiting at the facility

Licensing Program Analyst (LPA) Farhaan Sarangi arrived unannounced on to deliver amended the amended report originally dated for February 23, 2023 by Licensing Program Analyst (LPA), Erik Gonzalez Campos . LPA was greeted at the door by Business Office Manager, Debbie Spencer and was granted access into the facility.

LPA reviewed records and conducted interviews. LPA attempted to contact Resident 1’s (R1) Durable Power of Attorney (DPOA) on record. DPOA was not reachable. LPA contacted family listed in resident file who expressed no concerns regarding visitation of R1. Reporting Party (RP) also indicated that they have been allowed to visit R1 on multiple occasions. Per staff interviews, no one has been denied entry to visit R1. LPA toured memory care unit and observed R1 in the bedroom. R1 appeared to be in no distress. Based on the investigation, the allegation is unfounded meaning that the allegation is false, could not have happened and/or is without a reasonable basis. Exit interview conducted with administrator, Lydia Gravelyn. Report was emailed to admin. No deficiencies observed during today’s inspection.