Complaint Investigation Report

342701213-4-28-2026-27-AS-LKIG-DTVL98-20260508083307

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO SOUTH ASC , 9835 GOETHE ROAD, SUITE 100

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

04/22/2026 and conducted by Evaluator Avelina Martinez

COMPLAINT CONTROL NUMBER: 27-AS-20260422152033

Uncleared individuals are providing care and supervision.

Licensing Program Analyst (LPA) Avelina Martinez arrived at the facility unannounced on April 28, 2026, at 7:00 AM to open and deliver complaint findings, LPA Martinez met with Christin Pannell and explained the purpose of the visit.

Throughout the course of the investigation, LPA Martinez conducted interviews and reviewed facility files. It was learned that staff 1 (S1) was allowed to work at this facility prior to obtaining criminal record clearance documentation and approval from Community Care Licensing Department (CCLD). S1 worked at this facility from December 12, 2025 to April 17, 2026. Violation of Section 87355(e) shall result in an immediate assessment of civil penalties. A civil penalty in the amount $500.00 shall be assessed on April 28, 2026.

An exit interview was conducted, and a copy of this 9099 report, 9099-D Page, LIC421BG, and appeals rights documentation was provided to Christin Pannell.