Complaint Investigation Report

097001794-6-17-2024-59-AS-KHOS-D6GN5N-20240622100947

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

06/11/2024 and conducted by Evaluator Lavinia Muscan

COMPLAINT CONTROL NUMBER: 59-AS-20240611144324

On 6/17/24 Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to open and deliver complaint findings into the allegation listed above and met with Administrator Jennifer Hinch. During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

The Department received a report stating that the Authorized Representative did not receive a refund after a resident’s death. However, the Department received confirmation and documentation on 6/14/24 that a check was sent to the address on file. The LPA finds this allegation to be UNFOUNDED - meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Exit interview conducted and copy of this report was left with facility.