Complaint Investigation Report

397001983-6-23-2026-27-AS-LKIG-DWQVFD-20260807162347

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

05/28/2026 and conducted by Evaluator Kesha Lewis

COMPLAINT CONTROL NUMBER: 27-AS-20260528045657

Licensing Program Analyst (LPA) Kesha Lewis arrived at the facility unannounced to deliver findings for the above allegation. LPA was greeted by staff and administrator joined about 20 minutes later. LPA explained the reason for the visit.

Staff provided copies for LPA of R1'S care notes for the months of February -April. MARS for March and April, Holistic Approach check in and out notes. Medical and dental records and consult notes. After reviewing documentation and interviewing staff the allegation Staff hit a resident. is UNSUBSTANTIATED. R1 had not been in this facility for almost 3 months at the time of the complaint and been in an additional 2 place before the complaint was filed. There is nothing to suggest R1 was referring to this facility. As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegations may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview and a copy of the report was given.