Complaint Investigation Report

547208243-5-23-2022-24-AS-SMOA-CEXK9U-20220531074256

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

01/31/2022 and conducted by Evaluator Kelly J. McClurg

COMPLAINT CONTROL NUMBER: 24-AS-20220131164536

Assistant Administrator (AA) Javier Hernandez; Residential Site Supervisor (RSS) Michelle Garcia;

Unqualified staff providing medication to residents.

An unannounced visit was conducted on the dates & during the times indicated above by Licensing Program Analyst (LPA) K. Mcclurg. LPA met with Assistant Administrator (AA) Javier Hernandez & Residential Site Supervisor (RSS) Michelle Garcia.

The above allegation has been investigated by the Department. Based on discussion with AA & staff training records the Department has found the allegation to be substantiated

Exit interview conducted with AA & RSS. Records provided.