Complaint Investigation Report

347003994-9-5-2024-59-AS-MSEY-D8ZPKU-20240911112341

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

06/18/2024 and conducted by Evaluator Angela Hood

COMPLAINT CONTROL NUMBER: 59-AS-20240618163109

Licensing Program Analyst (LPA) Angela Hood arrived at the care home today, 9/5/24, and met with the Executive Director, Tracy Lehner, to deliver complaint investigation findings regarding the above stated allegation.

During the course of the investigation, LPA conducted interviews and obtained documentation pertinent to the investigation. Upon review of the facility's Payer Detail Ledger, dated 12/26/23-6/30/24, LPA observed that the facility does not owe the resident (R1) a refund. LPA obtained a copy of R1's admission agreement. LPA observed that the facility is complying with the terms and conditions set forth in the admission agreement.

Based on documentation reviewed, the above allegation is found to be UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. No deficiencies are being cited.

Exit interview conducted. A copy of the report was provided.