Complaint Investigation Report

342701084-5-2-2024-27-AS-SRIN-D5WMM5-20240604094318

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

04/22/2024 and conducted by Evaluator Victoria Brown

COMPLAINT CONTROL NUMBER: 27-AS-20240422144541

Facility staff forced resident to drink medicine

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct an investigation of the above mentioned allegations on 5/1/24 at 8:30a. LPA met with Emily Pascua and stated the purpose of the visit. LPA toured the facility and interviewed resident #1 (R1) - (R4) and the Administrator and Caregiver Randy Pozon during this visit. LPA requested a list of staff with contact information, food receipts, facility utility bills, and resident roster. There is 1 resident on hospice during this visit. Based on interviews and review of paid utility bills and food receipts for January - April 2024. The allegations above are deemed Unfounded.

"The allegation is UNFOUNDED, meaning that the allegation was false, could not have happened and/or was without a reasonable basis. This Department has therefore dismissed the complaint."

Per California Code of Regulations, no deficiencies were observed or cited. Exit interview held, and a copy provided.