Complaint Investigation Report

342701143-6-15-2023-27-AS-KHOS-CTMNRH-20230711104133

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO AC/SC , 2525 NATOMAS PARK DR. STE.270

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

10/07/2022 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20221007164831

On 06/15/2023, Licensing Program Analyst Renee Campbell arrived at Grove St. Care home to deliver findings for complaint 27-AS-20221007164831. LPA met with Manuel Sandoval, Licensee, and explained the purpose of the visit. The investigation was conducted by the Department which consisted of a review of records and interviews.

There were no direct witnesses or evidence to corrobate R1’s claim that a man punched her neck. Interviews revealed R1 was diagnosed with dementia and experienced hallucinations. Per physician, R1 injuries could have been from traumas such as a fall or automobile accident and cannot specifically determine how R1 sustained the injuries. At this time the coroner’s report is still pending and the RO is waiting to receive R1 death certificate.

As a result of this investigation. The Department finds the allegation unsubstantiated. Although the allegation may have happened, is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.