Complaint Investigation Report

565802430-11-16-2021-29-AS-JAPL-C8WQCL-20211119110315

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

11/09/2021 and conducted by Evaluator Ashley Smith

COMPLAINT CONTROL NUMBER: 29-AS-20211109135558

Staff has not posted the Ombudsman poster inside of the facility

Licensing Program Analysts (LPAs) Ashley Smith and Elsie Campos arrived unannounced for an initial 10-day complaint visit. The LPAs met with Administrator Dylan Hull and explained the reason for the visit.

During today’s visit, the LPAs conducted a physical plant tour at 9:00 a.m. and spoke with the Administrator.

Regarding the complaint, it was alleged that the facility did not have the Ombudsman poster in the facility. During the physical plant tour, whereas it was observed that the number to the Long Term Care Ombudsman (LTCO) was posted in the entryway, the facility did not have the required Ombudsman poster in the entryway. During today’s visit, the Administrator instructed staff to obtain the poster from the LTCO Ventura Office. Based on the investigation, this allegation is deemed Substantiated at this time. See 9099-D for deficiencies. Exit interview conducted. A copy of the report and appeal rights were issued.