Complaint Investigation Report

390313073-7-23-2025-27-AS-LKIG-DKCU8E-20250808152123

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

07/15/2025 and conducted by Evaluator Noel Wolf Petersen

COMPLAINT CONTROL NUMBER: 27-AS-20250715112301

Licensee is not ensuring that accurate records of residents' accounts of cash resources, personal property, and valuables are maintained.

Licensing Program Analyst LPA Noel Wolf Petersen, arrived at 12:45 on 7/23/25 unannounced to the facility, to investigate a complaint, the LPA met with facility administrator/licensee Darrel Gapasin and explainted the purpuse of the visit.

LPA is follow up to a complaint by VMRC, that the P&I logs were found to be accurate and current, they were not consistent with corresponding receipts and reflected frequent loan balances. The LPA looked over The P+I for the six residents, one was found to be out of order, found to be in excess of the amount on the p+I amount. The practices are consistant with the orginal complaint of P+I errors, the LPA gave guideance to the administrator about stewardship practices and responsibilities for the P+I. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is(are) found to be SUBSTANTIATED. California Code of Regulations citation is on the attached LIC 9099D.

A copy of the report was given to the administrator. appeal rights were provided.