Complaint Investigation Report

547209374-1-10-2026-24-AS-AWAN-DQJUC8-20260121142732

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

11/06/2025 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20251106212728

Administrator Alena Lema and Administrator David Shellhamer

Staff neglected resident of goods and services.

Staff neglected resident of physical care.

Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to conduct a complaint investigation. LPA explained the purpose of the visit and was granted entry by Medication Technician Jessica Onsurez. Administrator Alena Lema and Administrator David Shellhamer responded to the facility to assist with the visit.

LPA obtained a copy of the staff roster. Based on records review there was not a staff listed on the staff roster that are listed in this complaint. Based on interviews, the facility has not received any residents from the skilled nursing facility that is listed in this complaint.

Based on LPA's interviews and record review, this agency has investigated the complaint alleging, Staff neglected resident of goods and services, Staff neglected resident of physical care and Resident's health and safety endangered. We have found that the complaint was UNFOUNDED, which means it could not have happened, and/or is without a reasonable basis, therefore we have dismissed the complaint.

An exit interview was conducted and a copy of this report was provided.