Complaint Investigation Report

342700471-7-24-2024-59-AS-LMUZ-D7MVSW-20240729164212

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

04/15/2024 and conducted by Evaluator Cheyenne Ratajczak

COMPLAINT CONTROL NUMBER: 59-AS-20240415163244

Staff did not meet resident’s dietary needs

Staff did not comply with resident’s admission agreement

Staff did not treat residents with dignity and respect

On 07/24/24, Licensing Program Manager (LPM) Laura Munoz and Licensing Program Analysts (LPAs) Cheyenne Ratajczak and Graham Gunby arrived at the facility unannounced to deliver findings regarding a complaint the Department received on 04/15/24. LPA met with Executive Director (ED), Ricky David and explained the purpose of the visit.

During the course of the investigation, the Department conducted interviews and obtained pertinent documents relevant to the complaint investigation. Interview with ED revealed that Resident #1 (R1) does not live on the assisted living floors of the facility but on the independent living floor which is not licensed by Community Care Licensing (CCL). Interviews further revealed that the facility did have a meeting with R1 and stated that during the meeting the issues were resolved.LPA interviewed R1 during the interview it was revealed R1 is independent and does not need care and supervision. The department has investigated the complaint alleging resident dietary needs are not being met, staff did not comply with admission agreement and staff did not treat residents with dignity and respect. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Exit interview conducted and a copy of the report was left at the facility.