Complaint Investigation Report

507004675-7-5-2023-27-AS-SRIN-CU96GF-20230730204752

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 2525 NATOMAS PARK DR. STE.270

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

05/02/2023 and conducted by Evaluator Albert Johnson

COMPLAINT CONTROL NUMBER: 27-AS-20230502164144

Resident sustained an unexplained injury while in care

LPA was able to establish that the resident is transported by Storers and that there are serveral other residents that ride with R1. The driver for R1 denied witnessing or being party to the injury sustained by R1. The care home staff including the Adminstrator denied witnessing or being party to the injury sustained by R1 and the staff at the day program also denied witnessing or being party to the injury sustained by R1.

Based on this investigation, LPA was unable to determine how or where the bruise occurred. LPA was also unable to determine if this resident obtained injuries as a result of another resident's aggressive act, self injurious behaviors, facility staff, day program staff or by other means.

LPA finds allegation to be (US)Unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.