Complaint Investigation Report

455002689-6-9-2025-59-AS-KHOS-DHQHZH-20250617063821

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO NORTH ASC , 9835 GOETHE ROAD, SUITE 100

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

03/20/2025 and conducted by Evaluator Ivan Avila

COMPLAINT CONTROL NUMBER: 59-AS-20250320141435

Resident had ER visit due to unexplained bruising while in care

On June 9, 2025, Licensing Program Analyst (LPA) Ivan Avila conducted an unannounced complaint investigation visit regarding the above allegation directed by the Department. LPA Avila met with Angel Doss and explained the purpose of the visit.

LPA investigated the allegation, “Resident had ER visit due to unexplained bruising while in care.” Based on record review and interviews conducted it was revealed that none of the staff were aware of how the bruising formed. It was indicated that staff took C1 to the hospital when they noticed swelling from C1’s feet. Staff revealed that C1 has never been handled in an aggressive manner. Based on interviews and record review, staff addressed C1 appropriately and were responsive when staff noticed bruising on their feet.

Based on interviews conducted and observations, the preponderance of evidence standards have not been met. Therefore, the above allegation is found to be UNSUBSTANTIATED. Findings that the complaint is Unsubstantiated means that, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted, and a copy of the report was provided.