Complaint Investigation Report
342700902-11-8-2023-59-AS-LMUZ-CXN2JR-20231116162647
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
10/26/2023 and conducted by Evaluator Lavinia Muscan
COMPLAINT CONTROL NUMBER: 59-AS-20231026084013
Staff are not acknowledging resident's new POA documents.
On 11/8/23, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Director of Nursing Brian Pawloski. During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.The results of the investigation are as follows:
R1 was admitted to the facility on 7/27/23. Complaint allegations stated that R1 was placed in the facility against their will. Based on records reviewed and interviews, R1 has a family member as their POA. Based on R1’s medical diagnosis, R1 is not able to make decisions including the ability to change their POA. Staff are acknowledging that another family member wants to be POA, however, the facility cannot address that issue. LIC602 states that R1 is not medically competent to change the POA. Therefore, the allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.
Exit interview was conducted with Director of Nursing and a copy of this report was provided to the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction