Complaint Investigation Report

342700416-7-13-2023-59-AS-APEZ-CU72RY-20230728173818

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO NORTH ASC , 9835 GOETHE ROAD, SUITE 100

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

03/28/2023 and conducted by Evaluator Michael Hood

COMPLAINT CONTROL NUMBER: 59-AS-20230328154729

Marinela "Mary" Barac, Acting Administrator

Residents are chemically restrained with medication

Facility staff are not fingerprint-cleared

Licensing Program Analysts (LPAs) Michael Hood and Angela Hood arrived at the facility and met with Acting Administrator, Marinela "Mary" Barac, to deliver findings into the allegations listed above. LPAs spoke with Licensee, Sam Toplean, via phone call. Licensee gave permission to have Acting Administrator sign report.

During the course of the investigation, interviews were conducted, a medication count was conducted for residents (R1, R2, & R3), and documentation pertinent to the investigation was obtained. LPAs did not find any errors for Hydrocodone for R1. LPAs reviewed facility roster indicating that all staff working at the facility are criminal background check cleared. Interviews conducted with staff (S1 & S2) as well as R1 and resident (R4) indicated that they have never witnessed staff using drugs while on duty. Interviews with R1 and R4 indicated that they have never experienced abuse or witnessed staff abusing residents in care. Interviews with S1 and S2 indicated that they have not witnessed staff abusing residents.

Based on interviews conducted, documentation reviewed, and medication count, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are UNSUBSTANTIATED. No deficiencies are being cited during this visit.

Exit interview conducted. A copy of the report was provided to the Administrator.