Complaint Investigation Report

455002333-11-14-2023-59-AS-KHOS-CY3UGL-20231130143427

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

10/20/2023 and conducted by Evaluator Jaynae Boyles

COMPLAINT CONTROL NUMBER: 59-AS-20231020161333

On 11/14/23 Licensing Program Analyst Jaynae Boyles made an unannounced visit to the facility and met with Administrator Cameron Olson. The purpose of this visit was to deliver the results of a complaint investigation.

During the course of the investigation the administrator was interviewed. LPA reviewed the following documents: email correspondence with the property manager and ISP services. The administrator stated that the fence has been broken for many months and there have been challenges with getting the fence replaced, however it is required that the facility remain in good repair and the facility was without a fence for 8-10 months.

Based on interviews and evidence obtained during the investigation, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22), is being cited on the attached LIC9099D. Appeal rights were provided. An exit interview was conducted. A copy of the report was provided to administrator Cameron Olsen