Complaint Investigation Report

567609849-4-14-2023-29-AS-DPEA-D2UTFD-20240227134119

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

CCLD Regional Office , 21731 VENTURA BLVD. #250

This is an official report of an unannounced visit/investigation of a complaint received in our office on

04/12/2023 and conducted by Evaluator Teresa Camara

COMPLAINT CONTROL NUMBER: 29-AS-20230412125937

Facility does not provide food of the quality or quantity to meet the needs of the resident.

Licensing Program Analyst (LPA) Teresa Camara conducted an initial complaint investigation visit to the facility. LPA met with administrator Dadesii "DiDi" Daniel and explained the reason for the visit.

LPA conducted an interview with the administrator starting at 3:09 p.m. LPA interviewed staff 1 (S1) at 3:20 p.m. LPA reviewed client records at 3:43 p.m. LPA conducted a brief tour of the facility and inspected the food supply at 4:10 p.m. LPA found an insufficient supply of non-perishable food and bottled water. Perishable foods were insufficient in fresh fruit.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D):

Exit interview was conducted. Report and appeal rights were reviewed and emailed to the Administrator.