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13 | On 1/22/2026, at 1:35pm, Licensing Program Analyst (LPA) Zina Brown conducted an subsequent unannounced complaint investigation in order to deliver investigation findings for the allegation listed above.During today’s visit, LPA met with Catherine Dacara (Assistant Administrator), and explained the purpose of the visit.
The investigation consisted of the following: LPA requested copies of the staff roster (dated 10/01/2025), resident roster (dated 10/08/2025), Resident #1 (R1's) documents such as LIC 601: Identification and Emergency Form (dated 02/26/2025), LIC 602: Physician Report (dated 02/07/2025), LIC 603: Preplacement Appraisal Information, Functional Capability Assessment, Medication Administration Record (August 2025 - October 2025), Staff #1 (S1) documents such as LIC 501: Personnel Record/Job Application, Job Description (for Direct Care Staff), Interview Statement (dated 08/14/2025), ID/Driver License (Employment Authorization valid 08/02/2024 - 08/01/2028), Training Complete, Suspension Notification (dated 08/14/2025), Termination Statement (dated 08/25/2025), Report Receipt/Application for Release of Report from Long Beach Police Department.
The complaint was referred to the department Investigation Bureau for further investigation. The department obtained the Long Beach Police Department Report, Interviewed the Administrator (A1), Staff #1- Staff #3 (S1-S3), Interviewed Resident #1 (R1) and Witness #1 (W1). |