Complaint Investigation Report

471372608-5-16-2024-59-AS-KHOS-D5YLBC-20240606083632

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

03/27/2024 and conducted by Evaluator Sarah Benson

COMPLAINT CONTROL NUMBER: 59-AS-20240327160846

Staff did not provide adequate bed linens for resident.

Resident personal belongings are missing.

On 05/16/24 at 3:00 PM Licensing Program Analyst (LPA) Sarah Benson and Licensing Program Manager Lauren Crocker conducted an unannounced visit and met with administrator David and Erykah Small House Manager, Sandee Crane Administrator and Juanita Potts Licensee. The purpose of this visit was to deliver the finding of a complaint investigation.

Staff and Clients were interviewed and a tour of the facilty was conducted. While there was one Client who had reported money missing and another client reported a drivers license missing, there is no evidece that the missing articles were due to failure for the facility staff to safeguard the residents property. Further, during the visit the residents and facilty staff reported that the facility provides clean linens, further discussions around resident behaviors and documentation took place. The preponderance of evedence has not been met so the above allegations are UNSUBSTANTIATED.