Complaint Investigation Report

345920232-7-15-2026-59-AS-TORZ-DWLS88-20260803133843

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

07/09/2026 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 59-AS-20260709162518

facility not providing itemized bill for increase rent/care

facility not providing reassessment for increased care costs

Administrator failed to required notice regarding increase care costs

Licensing Program Analyst Hiratsuka, conducted the investigation into the allegation above.

LPA spoke to Administrator via the phone and then reviewed the resident's file. Administrator stated she did increase the rate and didn't give the proper notice. There was verbal increase notifications but not written. LPA left a copy of the CA Health and Safety Code for two types of rate increases with this report.

Based on the interview, the allegation is substantiated.

Based on the information gathered through interviews, LPA was able to determine that the allegation is substantiated. Therefore, the Department finds the allegation to be Substantiated. A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

Please see 9099-D for the deficiency sited