Complaint Investigation Report

392701057-11-9-2023-27-AS-LRIS-CXTTP5-20231122135344

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO SOUTH ASC , 2525 NATOMAS PARK DR. STE.270

This is an official report of an unannounced visit/investigation of a complaint received in our office on

09/25/2023 and conducted by Evaluator Albert Johnson

COMPLAINT CONTROL NUMBER: 27-AS-20230925125951

This matter was addressed and substantiated on the complaint report with the control number 7-AS-20230807125824 dated 8/28/2023. The facility was given a citation for mismanaging medication for R1 from 1/4/2022 thru 1/13/2022 and 2/6/22 thru 2/8/22. There were two medication not available for R1 on two different occasions. The facility's medication records confirmed that the medications were ordered but not available on-site.

The department concluded the initial investigation and the preponderance of evidence standard was met, therefore the above allegation is found to be SUBSTANTIATED. A citation was given on 8/28/2023 with a plan of correction, therefore the department will not be re- issuing a citation.