Complaint Investigation Report

390308140-9-30-2025-27-AS-LKIG-DMVUDB-20251028152917

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

06/03/2025 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20250603092629

Facility staff did not report incident per regulatory requirements

Staff member engaged in rough handeling of client

On 9-30-2025, 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.

This complaint is in regards to complaint number # 27-AS-20250617152516 that was SUBSTANTIATED and the facility cited. 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.

for citations see complaint # 27-AS-20250617152516.

An exit interview was conducted with administrator Candice Pelletier and a copy provided to facility via emaild due printer error.