Complaint Investigation Report

345002991-6-19-2024-59-AS-KHOS-D6GNL5-20240622103257

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

05/21/2024 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20240521104511

On 6/19/24, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with caregiver. The administrator was notified and arrived at the facility.

LPA conducted records review and interviews with caregivers and R1.

LPA is unable to find and or meet the preponderance, per policy.

Records showed R1 to have dementia and interviews found R1 to be regularly exit seeking. Interviews with staff found no staff reported to have hit R1 nor observed others to have hit R1. Interview with R1 found her to express wishes to go home and not recall where she currently resided or why she needed assistance. While LPA was present on 5/22/24 R1 vacillated between wishing to leave and saying she loved the staff. R1 moved from this facility to another RCFE until R1 can move home with family.

As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview with administrator. Copy of the report provided.