Complaint Investigation Report

097005046-8-5-2024-59-AS-LMUZ-D85Q5Y-20240814115239

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

05/08/2024 and conducted by Evaluator Lavinia Muscan

COMPLAINT CONTROL NUMBER: 59-AS-20240508113749

Staff violated resident’s personal rights by not allowing her to leave facility

On 8/5/24, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator Melisa Tiburcio.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.The results of the investigation are as follows:

Through the course of the investigation process, CCL conducted interviews, toured the facility, and reviewed records regarding the allegation above. During the investigation, it was determined that the care provider was trying to provide care and supervision to R1 based on the resident's needs and restraining order documents on file. The facility responded based on the most current documents they were provided. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are Unsubstantiated.

Exit interview conducted and copy of report provided to Administrator.