Complaint Investigation Report

342700157-9-23-2025-59-AS-LMUZ-DLZQCK-20250930120316

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

09/02/2025 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20250902103551

Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 09/23/25 to deliver complaint findings for the above allegations. LPA met with Staff, Flerida Manarang and explained the purpose of the visit.

Allegation- Staff overcharged resident. -UNFOUNDED

The department conducted record review and interviewed staff and relevant parties to investigate this allegation. Staff interview indicated that the facility charged community fee in the amount of $2000.00 when resident, R1 moved into the facility in August 2023 as R1 was waiting to be enrolled under Assisted Living Waiver Program (ALWP). Furthermore, it was learnt that the facility refunded this amount to R1s responsible party via cashier check on 09/05/25 once R1s responsible party brought this issue to facility’s attention. R1s responsible party confirmed this information to LPA during the complaint investigation and disclosed that this matter has been resolved. Record review verified that the facility refunded the requested amount to R1s responsible party as requested. Based on gathered information, this allegation was found to be UNFOUNDED. This agency has investigated this complaint. We have found the complaint was UNFOUNDED, meaning that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview was conducted and a copy of this report was provided to the facility.