Complaint Investigation Report

392700879-11-5-2025-27-AS-LKIG-DN72J2-20251106162536

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

09/18/2025 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20250918100257

On 11-05-25, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced deliver findings regarding the complaint investigation for the allegations noted above. LPA met with administrator Leah Davis and explained the purpose of the visit.

Based on doctumation provied by the facility and LPA being unable to contact resident the allegations above are UNSUBSTANTIATED. A finding of unsubstantiated means although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

There are no deficiencies is cited per California Code of Regulations, TITLE 22.

Exit interview was conducted with acting adminstrator Leah Davis and a copy of this report was left at the facility.