Complaint Investigation Report

392700368-10-18-2024-27-AS-KHOS-DAQMBV-20241105082833

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

07/30/2024 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20240730141410

Licensee did not provide resident with a general description of additional costs of the general increase for residents per the admission agreement

Licensee did not provide residents with changes in level of care that would result in an increase in monthly fees

On 10-18-24, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to continue a complaint investigation for the allegations noted above. LPA met with Administrator Marie Arbios and explained the purpose of the visit. LPA requested a copy of facility's admission agreement and other pricing structure documentation.

The facility was able to provide detailed information and show written policy about what is to be done when there is a price increase for the facility. LPA finds the facility followed the policy in the incidentsnotifiing resident on the price increase. Therefore, this complaint is UNSUBSTANTIATED. A finding that a complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted. copy of report given.