Complaint Investigation Report

392700578-4-1-2025-27-AS-KHOS-DFYPUK-20250422113739

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

02/13/2025 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20250213222950

a staff member was Requesting funds from a resident.

On 03-28-25, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to deliver complaint findings for the allegations noted above. LPA met with Administrator Isaac Herrera and explained the purpose of the visit.

LPA interviewed R1-R3 and S1. Based on interviews and the facility's own investigation during which S1 admitted to taking money, there is a preponderance of evidence to prove the alleged violations occurred, as a result the allegations are SUBSTANTIATED. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations.

The facility terminated the employee and reported all allegations as soon as the were learned of.

An exit interview was conducted and a copy of this report and appeal rights was provided.