Complaint Investigation Report

317002736-11-6-2024-59-AS-KHOS-DAWM2J-20241111081336

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

06/26/2024 and conducted by Evaluator Todd Tryon

COMPLAINT CONTROL NUMBER: 59-AS-20240626120926

Regarding the allegation that the facility is not reporting incidents, LPA spoke with staff, and is not able to ascertain whether there may or may not have been times that incidents were not reported in the past. The facility has reported some incidents when they occurred. At this time, LPA finds the allegation to be unsubstantiated.

A finding that an allegation is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the the alleged violation occurred.

No deficiencies were cited at this visit.

Exit interview conducted; appeal rights provided.