Complaint Investigation Report

547201120-1-19-2022-24-AS-MHON-CBBPN3-20220204102713

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

11/18/2021 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20211118090221

Neglect/lack of care and supervision resulted in the resident sustaining a pressure injury.

Neglect/lack of care and supervision resulted in the resident being hospitalized for malnutrition.

On 01/19/2022, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit and requested to meet with Administrator. LPA met with Administrator, Esmeralda Coronado.

The Department investigated the above allegations and although the allegations may have happened or are valid, there is not a preponderance of evidence to prove they did or did not occur therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted. As a COVID-19 precautionary measure, a copy of this signed report will be provided via email and an electronic read receipt confirms receiving this document.