Complaint Investigation Report

547208825-7-22-2022-24-AS-SPIY-CGPKYV-20220726081948

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

07/21/2022 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20220721090829

Licensing Program Analyst (LPA) Shawna Doucette contacted the facility to commence a complaint investigation. LPA identified herself and discussed the purpose of the visit and the elements of the allegations with Lead Staff John Castillo. LPA contacted Administrator Kerri Cole who gave permission for Lead Staff John Castillo to sign for this report.

LPA conducted interviews and reviewed records. It was found facility had roaches since April 2022 and facility did not contact pest control service until July 2022. LPA obtained copies of pest control service receipts.

Based on staff interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8, Section 80087(a)(1) is being cited on the attached LIC 9099D.

An exit interview was conducted, a copy of this report was provided, and appeal rights were provided.