Complaint Investigation Report
392700793-5-30-2025-27-AS-KHOS-DHALQK-20250603085740
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
04/02/2025 and conducted by Evaluator Kesha Lewis
COMPLAINT CONTROL NUMBER: 27-AS-20250402151451
Facility staff restrained resident in care.
On 05/30/25, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to deliver findings for the allegations noted above. LPA met with Staff and explained the purpose of the visit.
Based on interviews done conducted by LPA Lewis of R1 and S1 and interviews conducted by Valley Mountain Reginal, the allegation Facility staff restrained resident in care is UNSUBSTANTIATED. R1 admits they were mad about other personal issues and accused S1 out of anger.
Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegation of Facility staff restrained resident in care. unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed.
There are no deficiencies is cited per California Code of Regulations, TITLE 22.
Exit interview was conducted, and a copy of this report was left at the facility.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction