Complaint Investigation Report

342700070-12-10-2024-59-AS-MSEY-DBUSRD-20241211130607

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

12/09/2024 and conducted by Evaluator Sabrina Calzada

COMPLAINT CONTROL NUMBER: 59-AS-20241209000714

Staff inappropriately shove a resident while in care.

Staff deny a resident a resident from using their walker.

Staff are mistreating a resident while in care.

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a 10-day inspection and met with Lourdes dela Paz, Administrator. Staff, Jovylito Madum, was also present. LPA observed (3) clients present and (1) client return from day program during today's inspection. LPA discussed the allegations with the Administrator, including the first name of the client who the allegations pertain to. The Administrator and staff stated there is not currently a client with this name living at the care home. Also there are no clients who currently use a walker, and all clients are essentially non-verbal. It was also confirmed the police did not visit the care home last night. Staff, Richard Durmol, was contacted by phone today and confirmed the Ombudsman also visited this care home yesterday due to the incorrect address listed.

Based on information obtained, this complaint was inadverently opened under the incorrect facility and findings are UNFOUNDED- An unfounded allegation means that the allegation was false, could not have happened and/or is without a reasonable basis. Exit interview conducted. A copy of this report was left at the facility.