Complaint Investigation Report

547203298-6-2-2026-24-AS-LXIG-DUNSYP-20260602141753

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

08/29/2025 and conducted by Evaluator Les Xiong

COMPLAINT CONTROL NUMBER: 24-AS-20250829085950

“This report is being amended to update the reporting manager.”

Staff did not provide nutritious meals to residents in care

Staff did not store perishable foods in covered containers

Staff retained expired foods at the facility for residents in care

Licensing Program Analyst (LPA) L. Xiong conducted the complaint investigation to the facility. During the course of this investigation, LPA reviewed facility files relevant to the complaint and conducted a facility tour.

It was determined that the above allegations: Staff did not provide nutritious meals to residents in care, Staff did not store perishable foods in covered containers, and Staff retained expired foods at the facility for residents in care are SUBSTANTIATED.

The evidence from the investigation indicated that the facility is not practicing proper storing of food. Facility did not have food labeled and dated, they were not utilizing proper freezer storage and were storing food in broken and dirty refrigerators. Facility was not following a menu and would cook meals that were “going to expire”. It was observed that residents received a hamburger and cauliflower for lunch. The hamburger did not include any condiments or toppings. The facility received food from a local food bank that were close to the best buy date and did not prepare the meals prior to the best buy date.

The deficiencies for this complaint were issued during a case management visit conducted on 10/23/2025. Licensee has submitted a closure plan for the facility.

Exit interview conducted. A copy of this report was discussed and provided to Licensee, whose signature on this form confirms receipt of this document.