Complaint Investigation Report

547203298-4-12-2024-24-AS-KHOS-DBUNZM-20241211095435

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

01/19/2024 and conducted by Evaluator Les Xiong

COMPLAINT CONTROL NUMBER: 24-AS-20240119160237

Licensing Program Analyst (LPA) L. Xiong conducted the subsequent complaint investigation visit to the facility. LPA met with Licensee Lisa Ong and informed her the purpose of the visit.

During the course of this complaint investigation LPA interviewed staff on duty and obtained and/or reviewed facility records. It was determined based on the interviews and records review that the above allegations are SUBSTANTIATED. There were a wall in the shower/bathroom across from the laundry room that were not completely repaired and the toilet wasn't flush. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.”)