Complaint Investigation Report

490108263-3-1-2022-21-AS-HDBI-CCD2K4-20220309162720

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

01/18/2022 and conducted by Evaluator David Leibert

COMPLAINT CONTROL NUMBER: 21-AS-20220118120334

Licensing Program Analyst Leibert arrived unannounced for the purpose of delivering findings on this complaint. LPA met with Gus Guevarra and discussed the findings. C1 was sent out for medical treatment on January 18, 2022 when client experienced difficulty breathing. While hospitalized a report was received that client had lice and scabies. This Department has investigated the allegation by making site visits, conducting interviews and reviewing documents. The following determinations are made: Facility staff deny observing lice on C1 and state Client's bedroom was swept and found to be free of lice; C1 has made contradictory statements regarding having lice/scabies; A licensed professional has stated to have observed C1 infested with lice which appeared to be in various stages of development; medical report obtained from the medical facility lists Lice as one of the medical diagnosis. Based upon the statements and records, the preponderance of evidence standard has been met. Therefore, the allegation is deemed to be SUBSTANTIATED.

The following deficiencies were observed (see LIC 9099D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.