Complaint Investigation Report

392700661-4-11-2025-27-AS-LKIG-DFTKVR-20250417081442

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

11/26/2024 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20241126101855

Staff do not provide adequate care and supervision of the clients

Staff do not ensure the facility has household products available for the clients

On 01/08/25, Licensing Program Analyst (LPA) Kesha Lewis and Licensing program manager (LPM) Liza King arrived unannounced to continue the complaint investagation for the allegations noted above. LPA met with staff explained the purpose of the visit.

Based on observations and interviews with residents and the a visit from valley mountain regional (VMRC) on 12/06/2024 During the visit from VMRC residents were found to be in the facility with no staff by VMRC legasion Isebella Dalman. Based on interview with administrator Luis where he stated he would had out toiletries to residents the allegation of Staff do not ensure the facility has household products available for the clients is also SUBSTANTIATED.

the complaint is determined to be SUBSTANTIATED. As a result, the preponderance of evidence standard for this allegation is met, therefore, this allegation is SUBSTANTIATED.

Deficiencies already cited see complaint dated 12/11/2024.