Complaint Investigation Report

547209130-6-29-2023-24-AS-SPIY-CTDVRX-20230703164041

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

04/11/2023 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20230411152417

Resident sustained unexplained injury while in care

Licensing Program Analyst (LPA) Shawna Doucette conducted an unannounced complaint inspection to deliver findings. LPA explained reason for inspection and was granted entry by Administrator Kristyn Leyva.

LPA conducted interviews and reviewed C1's file. C1 has behaviors that could have caused injury and it was unable to be determined how or where the client obtained the injury.

Based on interviews, it is undermined if a Resident sustained unexplained injury while in care. 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.