Complaint findings: substantiated, inconclusive and unfounded

1. Anyone can file a complaint by phone, email or online. CDSS says complainants stay anonymous unless they give permission to use their name.
2. The local licensing office makes an unannounced visit to investigate within 10 days of receiving the complaint.
3. A Licensing Program Analyst or enforcement analyst investigates: visiting, interviewing and reviewing records.
4. Each allegation gets a finding, written up on a Complaint Investigation Report (LIC 9099). Any citations go on a Facility Evaluation Report (LIC 809).
5. If the person who complained left contact information, CDSS sends written notice of the findings when the investigation is complete.

The time an investigation takes depends on how complex it is. If no determination can be reached at the end of the visit, the LIC 9099 has a "Needs Further Investigation" box with an estimated number of days to complete.

Substantiated

The allegation is valid because the "preponderance of the evidence" standard has been met. CDSS's complaint page puts it as the evidence showing the allegation is more likely than not true. A substantiated allegation usually comes with a citation for the rule that was broken.

Inconclusive (also called unsubstantiated)

The allegation may have happened or may be valid, but there is not a preponderance of the evidence to prove the violation occurred. It is not a finding that the facility did nothing wrong, and not a finding that it did.

Unfounded

The allegation is false, could not have happened, or is without a reasonable basis.

CCLD has used two words for the middle finding over the years. Its older complaint log (LIC 957, 10/99) lists the resolution codes as Substantiated, Inconclusive or Unfounded, and says an allegation is inconclusive "if it may have happened but cannot be proven." The current complaint report form (LIC 9099, 12/16) uses Substantiated, Unsubstantiated and Unfounded, with the same meaning for the middle one, so on newer reports unsubstantiated is the word for what older records call inconclusive.

The state's facility record keeps separate counts for the two words. This site adds them together and shows the total as Inconclusive, so a facility's count isn't split depending on when its complaints were filed.

• A substantiated allegation that breaks a licensing rule is cited on a Facility Evaluation Report (LIC 809) with a plan of correction and a due date, and civil penalties can follow if it is not corrected in time (Title 22 §80052 and §80054).
• Serious or repeated problems can lead to stronger enforcement. The regulations give the Department the power to revoke or suspend a license (§80042), and a license can be placed on probation through a formal enforcement case; see what probation means.
• The licensee can disagree. The back of the inspection and complaint forms explains that a licensee may discuss a disagreement with the licensing agency and request a review in writing within 15 business days.

One complaint often contains several allegations, for example one about staffing and another about medications, and each gets its own finding. The totals on a facility page are allegation counts, so a single complaint can add several to them.

Each facility page also lists its individual complaint reports when they're saved, with the finding for each allegation, so you can read what was alleged rather than relying on totals.

• Substantiated allegations deserve the closest read. Open the report and see what happened and what was cited.
• Inconclusive is genuinely uncertain. Several inconclusive allegations about the same issue can still be worth asking about.
• Unfounded means the state found no basis. It shouldn't count against a facility.
• Size and age matter. A large home with more clients and more years licensed will usually have more complaints of every kind.
• Confidential reports aren't public. CCLD says some complaint reports may be confidential depending on the allegations and findings, so the public record may not show everything.

When you visit a home, it is reasonable to ask about any substantiated complaints and what the facility changed afterward. The touring questions guide has more ideas. New complaint reports statewide show up on Recent changes.