Complaint Investigation Report
342700317-9-10-2024-59-AS-KHOS-D92J6U-20240912064654
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
09/06/2024 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20240906162443
Client wandered away from the facility due to lack of care or supervision from staff .
Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 09/10/24 to do the complaint investiagtion for above allegation. LPA met with administrator Nelson Jacinto and explained the purpose of the visit. LTCO, Byron Toliver was also present during this visit.
From record review, administartor and resident (R1) interviews, it has been concluded that R1 AWOL from facility on 09/05/24 sometime after 11AM and was located at El Hogar Clinic, 630,Bercut Drive, Suite # C, Sacramento,CA,95811 (19 miles away from facility) and El Hogar staff notified facility regarding R1s presence at the clinic around 1PM. It was indicated that R1 was very thirsty and clammy when Clinic staff found R1. R1 was transferred to local hospital to get medical care and discharge to facility on 09/05/24 around 10PM. R1s LIC602 ,dated- 01/17/24 signed by thier physician disclosed that R1 cannot leave facility unassisted. From all gathered information, it has been conlcuded that R1 had AWOL from facility unassisted and unsupervised on 09/05/24 due to lack and care from facility. Based on interviews conducted by the department and records reviewed, the preponderance of evidence standards has been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22 Division 6, Chapter 8, a deficiency is cited.Exit interview was conducted .Copy of the report and appeal rights were left provided. Civil penalties shall be assessed if facility does not comply with POC requirements which were issued today.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction