Complaint Investigation Report

315001968-4-24-2025-59-AS-KHOS-DG7NH4-20250429102807

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

03/24/2025 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 59-AS-20250324162310

Licensing Program Analyst (LPA) Hiratsuka conducted this complaint visit.

LPA interviewed staff and witnesses. The above incident did occur where two staff members approached a resident who will refuse showers and staff were caught attempting to force the resident into the shower with one holding the resident by the wrist and one holding the resident by the waist. A third staff member intervened and the other two staff members left the room. Resident did not sustain any injuries.

Based on the above the allegation is substantiated.

Based on the information obtained for the allegations above, the allegations are SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

Exit interview conducted with Senior Executive Direcotor Penny Zehnder and a copy of the report and appeal rights was provided.