Complaint Investigation Report

315001780-7-26-2024-59-AS-MSEY-D83P2K-20240812105605

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

07/19/2024 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20240719160546

Facility staff are not ensuring that an appropriately skilled professional is

On 7/26/24, Licensing Program Analyst (LPA) Kevin Mknelly LPA Mknelly arrived and met with Administrator to investigate and deliver investigation findings.

LPA reviewed resident R1 records and interviewed the licensee.

LPA finds that facility met Tittle 22 requirements.

R1 was a resident 5/4/24- 7/5/24. LIC 602 stated R1 independently managed his injections. Discharge inventory found R1 had excess supplies of alcohol pads for his tests and injection. Licensee observed R1 tests and injections. R1 had made proceudres.

Previous allegations that the department investigated on 6/28/24 that were unfounded.

LPA received copies of R1's LIC 602, inventory and emergency contact.

This agency has investigated the above complaint allegations. We have found that the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Exit interview conducted and report provided.