Complaint Investigation Report

397005466-10-7-2025-27-AS-LKIG-DMESM3-20251013135916

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

10/03/2025 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20251003102613

Facility does not employ adequate staff to meet the residents' needs.

Residents do not received assistance from staff in a timely manner.

Residents are left in soiled for extended period of time.

Licensing Program Analyst (LPA) Kesha Lewis arrived at the facility unannounced to open a complaint for the above allegations. LPA was greeted by staff and explained the reason for the visit.

Based on the information provided by the reporting party and the actual rooms in the facility this can not be a correct facility. There is a discrepancy in the room numbers provided in the complaint to the rooms that are in the facility. LPA did not observe a preponderance of evidence standard therefore the allegations are UNFOUNDED. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies are being cited.

“This agency has investigated the complaint alleging the above mentioned allegations. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.”

An exit interview was held, and a copy of this report was given.