complaint·October 2, 2024

On 10/02/24 LPA conducted interview with Executive Director (ED) regarding the above allegation, ED confirmed the allegation above. Per ED, an employee who is no longer employed at the facility was in charge of submitting SIRs and ED is unsure why the SIR was not submitted. On 10/02/24 LPA conducted interview with staff #1 (S1) regarding the allegation above, 1 of 1 staff interviewed confirmed that there was no incident report submitted for the death of R1 as a previously employed staff who was in charge of submitting reports to the licensing department did not complete the required report. S1 continued to report that S1 is now the employee responsible for submitting incident reports to the licensing department. Based on LPAs observations and interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division (6) and Chapter (8) are being cited on the attached LIC 9099D. Exit interview conducted, appeal rights explained, and a copy of this report was provided.