Complaint Investigation Report

392700752-4-27-2026-27-AS-LKIG-DTZSDZ-20260512134757

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

02/27/2026 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20260227114300

the facility failed to provide care and supervision to meet a clients needs.

the facillity failed to accord a client access to, and/or use of a personal item.

Licensing Program Analysts (LPA) Kesha Lewis arrived unannounced to deliver findings for the above allegations. LPA met with the facility manager; Joanny Rincon LPA explained the purpose of the visit.

Based on records review and interview of staff. LPA could not interview Resident (R1) as they had moved from the facility on 3/30/2026. The allegation list above are UNSUBSTANTIATED, a finding of UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a ponderance of the evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

Exit interview was conducted and a copy of the report was given to the facility manager, Joanny Rincon. No citations were issued per Title 22 regulations.