Complaint Investigation Report

045002778-1-30-2024-59-AS-KHOS-D27JTG-20240206061954

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO NORTH ASC , 9835 GOETHE ROAD, SUITE 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

01/29/2024 and conducted by Evaluator Donna Gurriere

COMPLAINT CONTROL NUMBER: 59-AS-20240129122625

Staff did not provide medication as prescribed.

Staff altered a resident's medication without consent.

Staff did not provide adequate supervision resulting in excessive falls.

On 01/30/24 Donna Gurriere, Licensing Program Analyst (LPA) arrived at the facility unannounced to deliver final findings regarding a complaint that was received on 12/27/23. LPA Gurriere met with Don Daniels, Resident Care Coordinator and explained the purpose of the visit.

It was determined that the complaint allegations were listed under the wrong Roseleaf facility; therefore, the allegations are unfounded. A new complaint with the allegations are transfered this date to the correct facility, which is Roseleaf Gardens, #045002775.

Due to the information above, the Department finds the allegations to be Unfounded. A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis.