Complaint Investigation Report

342701489-8-22-2025-27-AS-LRIS-DLDPPV-20250910113010

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO SOUTH ASC , 9835 GOETHE ROAD, SUITE 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

04/14/2025 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20250414104810

Staff did not use the proper equipment to move resident in care resulting in injuries to resident.

On 08/12/2025, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility unannounced to close a complaint. LPA Campbell met with Licensee Beatrice Clark and explained the purpose of the visit.

Regarding the allegation staff did not use the proper equipment to move resident in care resulting in injuries to resident, resident reported having a skin tear and reported she had hurt her arm because the bed pinched it, not because of staff. When LPA Campbell asked about the injury, X3 stated two staff had assisted her but she didn’t remember their names. The Hoyer lift was not used and was not required per the residents 602. Instead, X3 reported that staff help her out of bed 2 at a time.

Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED.