Complaint Investigation Report

vegetables from the person who does their CPR training. The vegetable donor also owns their own facility. The donated brussel sprouts and spaghetti squash were observed to be spoilt and were tossed by staff during the tour of the pantry.

Per tour of the back building used as the facility's pantry, LPA observed sufficient perishables such as ground beef, trays of chicken, hamburger patties, rounds of beef, turkey breasts, green beans, zucchini, cabbage, lettuce, turkey lunch meat, oranges, gallons of milk, spaghetti squash, grape tomatoes, a case of eggs, ground turkey, fish sticks, hot dog buns, frozen strawberries and packaged greens in the freezer and refrigerator for a minimum of 2 days. Per review of the non-perishable foods, LPA Yee observed, canned applesauces, containers of lemonade mix, a half a container of rice, a bag of butter milk pancake mix, 4 bags of cereal, cookies, cans of chicken noodle soup, cans of chicken broth, 2 bottle of ketchup, 2 bottles of yellow mustard, 3 large cans of corn hash, 2 large cans of Beef Ravioli, 2 large cans of marinara sauce, 4 large cans of tuna, 4 large cans of chili sauce with beans, 6 boxes of top ramen and cases of water. LPA Yee did not observe any cans of vegetables, pastas/noodles, potatoes, or other snacks except for cookies to allow for 3 snacks a day. Based on the ingredients and supplies observed in the pantry, the Administrator was asked to create 3 balanced meals a day and 3 snacks for 7 days for a capacity of 24 residents and he agreed, that there was insufficient non-perishable foods maintained on the premises to create the required meals and snacks to last for a minimum of seven days.

Based on the interviews conducted with Staff, Administrator and a tour of the back building serving as the facility's pantry, there is sufficient evidence to support the allegation that staff does not ensure facility has adequate food supply.

Deficiencies cited under California Code of Regulations, Title 22, Division 6, Chapter 8.

Exit interview was conducted, Appeals Rights were discussed and a copy was provided.