Complaint Investigation Report

342700385-11-20-2024-27-AS-KHOS-DB7TYB-20241120140829

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

11/12/2024 and conducted by Evaluator Victoria Brown

COMPLAINT CONTROL NUMBER: 27-AS-20241112143723

AMENDED TO CHANGE TO PUBLIC Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on 11/14/24 at 2pm and met with Administrator stating the purpose of the visit. During interviews, Administrator iindicated because the television was so loud and was using the phone regarding R2, they did not hear either doorbells. Administrator stated that the front door does not automatically lock. On 11/11/24 there were 3 other residents in the home. LPA observed R1 records which indicate a history of fabrications, able to leave the facility unassisted, and carriers extra continence supplies. A review of Facility Notes and Assessments, allegation is deemed Unsubstantiated based on observation that the 2 doorbells work, and television being utilized loudly by residents, it is unclear if staff heard the bell(s) if it was used or not. The investigation revealed the preponderance of evidence standards has not been met; therefore, the above allegation(s) is found to be UNSUBSTANTIATED. A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, no deficiencies cited. An exit interview was conducted, and a copy of this report was provided.