Complaint Investigation Report
500309303-2-12-2025-27-AS-LRIS-DE7PSZ-20250224103507
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
02/05/2025 and conducted by Evaluator Renee Campbell
COMPLAINT CONTROL NUMBER: 27-AS-20250205120513
Staff did not ensure resident's oxygen tanks were secured in a stand
On 02/12/25, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility unannounced to open a complaint. LPA Campbell met with Sarah Rico, House Manager, and explained the purpose of the visit.
Regarding the allegation that staff did not ensure resident's oxygen tanks were secured in a stand,
LPA Campbell interviewed staff and conducted a search for unsecured oxygen tanks in R1's (R1) room. Staff 1 (S1) stated that R1's oxygen was with them at all times and at night. LPA Campbell also observed R1 with his oxygen in the living room. The tank was a DeVilbiss 5 Liter Oxygen Concentrator which is not an oxygen tank but a method of gathering oxygen from the surroundings and concentrating it for breathing.Emergency oxygen tanks were observed in the locked medicine closet in the office in a stand.
Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, and therefore this allegation is UNSUBSTANTIATED. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6 no deficiencies cited. Exit interview was held and a copy of report was given to Sarah Rico.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction