Complaint Investigation Report

342700722-1-30-2025-27-AS-SRIN-DEBPRE-20250228103238

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

01/29/2025 and conducted by Evaluator Victoria Brown

COMPLAINT CONTROL NUMBER: 27-AS-20250129113614

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced, conducted a complaint investigation on 1/30/25 at 1:30p. LPA met with Elena Cuevas, Executive Director and stated the purpose of the visit.

LPA requested staff work schedules to include any changes, LIC500 with staff contact, resident roster. LPA conducted interviews with Executive Director and Health and Wellness Director. LPA received a copy of the Incident report dated 11/22/24 which was self-reported to Communicuty Care Licensing (CCL) which was investigated on 12/3/2024. LPA received all requested documents for dates: 7/22/24, 7/29/24, 12/23/24, 12/24/24, 12/30/24. 1/21/25, 1/26/25, 1/27/25, 1/28/25. LPA reviewed QuickMar with S2 for the past 6 months. LPA did not observe that any residents missed medications.Based on interviews, documentation, and that there was no incidents that occurred, the preponderance of evidence has not been met. "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.