Complaint Investigation Report

397005036-1-22-2025-27-AS-LKIG-DDEQUD-20250130112832

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

01/16/2025 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20250116102201

Staff are not providing an adequate supply of food.

Licensing Program Analyst (LPA) Kesha Lewis arrived at the facility unannounced to open an complaint for the above allegations. LPA was greeted by staff and explained the reason for the visit.

LPA Lewis interviewed R1-R3 and S1 regarding the above allegations. Based on interviews with staff and residents and observatiosn by LPA Lewis of the the food supply. The above allegations are SUBSTANTIATED. As a result, the preponderance of evidence standard for this allegation is met, therefore, this allegation is SUBSTANTIATED.

Deficiencies cited see 9099D page per California Code Regulation, TITLE 22.

Exit interview was conducted and a copy of the report and appeal rights given.