Complaint Investigation Report

345002933-10-19-2023-59-AS-KHOS-CWWGD2-20231024051424

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

04/12/2023 and conducted by Evaluator Cassie Yang

COMPLAINT CONTROL NUMBER: 59-AS-20230412145121

Licensee admitted resident without a medical assessment signed by a physician within one year.

Licensee prohibited resident from having visits.

Licensing Program Analysts (LPAs) Cassie Yang and Cheyenne Ratajczak arrived unannounced at the facility to deliver the findings of the allegations cited above. LPAs met with Assistant Administrator, Kassie Howell, and explained the purpose of the visit.

During this investigation, the Department conducted interviews and file reviews.

At this time, the allegations listed above has been detemined as unfounded, as the alleged incident occured at a different facility. UNFOUNDED-means that the allegation is false, could not have happened, and/or is without a reasonable basis.

LPAs will open a new complaint to the correct facility.

Exit interview and acopy of the report and appeal rights provided.