Complaint Investigation Report

502700633-7-29-2026-27-AS-LKIG-DWQVES-20260807162248

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

07/23/2026 and conducted by Evaluator Noel Wolf Petersen

COMPLAINT CONTROL NUMBER: 27-AS-20260723162822

Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility to investigate the above allegtions. LPA met with administrator Dee Fernando and explained the purpose of the visit.

LPA interviewed the administrator, who gave the statement she did not evict R1, she was expressing the opinion of the oncologist that r1 should recive a higher level of care. In a record review of the call log, the administrator expressed that the clients needs were different and he was not welcome back ot the facility, on july 23, and july 25th to Social worker S1 at doctors medical hosptial. LPA gave guidance that even when a administrator determines a client is unsafe to come back to the faciltiy because of changes to thier care, it is an attempt to evict the resident unlawfully if the reappriasal is not completed and a 30 day written notice is not served.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Cited on following D Page.A copy of the report was read and given to the administrator. appeal rights were provided and exit interview was conducted.