Complaint Investigation Report

045002440-7-30-2026-59-AS-LMUZ-DWQQHN-20260807121124

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

07/21/2026 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 59-AS-20260721155220

Lack of staff supervision resulting in resident sustaining fracture. - UNFOUNDED

Staff did not respond to resident's call light in a timely manner. - UNFOUNDED

Staff did not report incident to responsible party. - UNFOUNDED

07/30/2026 09:10 AM Licensing Program Analyst (LPA) Rebecca Knight made an unannounced visit to the facility and met with Executive Director Irene Davis. The purpose of this visit was to deliver the results of a complaint investigation.

During interviews it was learned that the resident that the complaint concerns has never lived at the facility. This complaint is unfounded.

This agency has investigated the complaint alleging a personal rights violation. We have found the complaint was UNFOUNDED, meaning that the allegations qre false, could not have happened, and/or is without a reasonable basis.

No deficiencies cited. Exit interview conducted and a copy of the report was provided to Executive Director Irene Davis