Complaint Investigation Report

392700475-1-7-2026-27-AS-KHOS-DJFL34-20250710082318

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

05/08/2025 and conducted by Evaluator Albert Johnson

COMPLAINT CONTROL NUMBER: 27-AS-20250508090354

Staff are charging a resident for services not received

Licensing Program Analyst (LPA) Albert Johnson arrived at facility unannounced to amend the finding to unfounded.

The Department reviewed documents received and information obtained through interviews. It was found that residents and their responsible parties were provided a 60-day notice of a price increase and there were no significant changes to the Plan of Operation that needed to be provided to the licensing agency for approval.

Based on the above, the facilities' appeal has been granted, and the deficiency will be dismissed.