Complaint Investigation Report

502700165-5-31-2024-27-AS-KHOS-D65NES-20240611102426

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO SOUTH ASC , 9835 GOETHE ROAD, SUITE 100

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

03/08/2024 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20240308091653

A visit was conducted on 05/31/24 with Direct Support Provider Vanessa Oliva to amend the document from the 03/14/24 visit. The document below is an amendment to the prior report.

On 03/14/24, LPA Renee Campbell arrived to conduct a visit to present findings. LPA Campbell met with Administrator Tanisha McNeal and explained the purpose of the visit.

Based on interviews with family and staff and document reviews, R1 has made several different statements regarding being hit by S1. R1 has been interviewed by staff with and without their parent and the statements made by R1 have not be consistent. Also, there were no other witnesses present during the alleged altercation. Of the three staff interviewed, neither S6, S4, or S2 witnessed the event and S10 confirmed no other staff were scheduled. The Department is therefore unable to determine if S1 hit R1. The allegation is therefore unsubstantiated.

Complaint allegation findings of UNSUBSTANTIATED mean that 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. No deficiencies issued per Title 22 regulations. Exit Interview. Copy of report provided to facility representative.