Complaint Investigation Report

345003004-2-22-2024-59-AS-MSEY-D34T9W-20240306133238

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

02/20/2024 and conducted by Evaluator Angela Hood

COMPLAINT CONTROL NUMBER: 59-AS-20240220102745

-Staff placed locks on the resident's door that violates the facility fire clearance

-Staff did not ensure the facility had a working telephone

Licensing Program Analyst (LPA) Angela Hood arrived at the care home unannounced today, 2/22/24, and met with the Administrator, Persida Pop, to open a complaint and deliver complaint investigation findings regarding the above stated allegations.

During today's visit, LPA tested the facility phone and observed all the doors in the facility. The facility has an operable phone line for residents' use. None of the facility doors prevent residents from exiting their bedrooms or the care home.

Based on observation, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. No deficiencies are being cited.

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