Complaint Investigation Report

392701304-4-3-2025-27-AS-KHOS-DFRKDA-20250415074826

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

03/03/2025 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20250303092730

Facility staff took inappropriate photo of resident

Licensing Program Analyst (LPA) Kesha Lewis arrived at the facility unannounced to deliver complaint findings for the above allegation. LPA was greeted licensee and explained the reason for the visit.

Allegation 1 Facility staff took inappropriate photo of resident is SUBSTANTIATED. Based on LPA interviews with reporting party, S1 and adminstrator, LPA found the allegation was true, R1'S responsible party was not asked and did not give approval for photos to be taken of R1. The Department has investigated the complaint listed above and based on the investigative interviews, record reviews and other supportive evidence, 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 cited see 9099D page per California Code Regulation, TITLE 22.

Exit interview was conducted and a copy of the report and appeal rights given.