Complaint Investigation Report

390308140-8-15-2025-27-AS-LKIG-DLJSVR-20250915141310

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

06/17/2025 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20250617152516

Staff yelled at client in an inappropriate manner

On 8-15-2025, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to deliver findings for the above allegations. LPA met with Program Director Candice and explained the purpose of the visit.

Based on interviews with staff and video evidence on the incident. The preponderance of the evidence standard has been met therefore the allegations Staff handled client in a rough manner and

Staff yelled at client in an inappropriate manner are SUBSTANTIATED. The finding that the complaint is substantiated means that the allegation is valid because the preponderance of the standard has been met.

Deficiency cited on the LIC 9099-D, per Title 22 Regulations.

An exit interview was conducted with administrator Candice Pelletier and a copy of this LIC 9099, LIC 9099-D page and appeal rights provided to facility.