Complaint Investigation Report
502701087-4-12-2024-27-AS-LRIS-D4DPGT-20240416111853
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
04/04/2024 and conducted by Evaluator Maja Jensen
COMPLAINT CONTROL NUMBER: 27-AS-20240404104236
Staff did not provide residents authorized person copies of resident's records
On 4/12/24 at approximately 10:45 Licensing Program Analyst (LPA) Maja Jensen arrived at facility unanounced to open a complaint investigation in to the above listed allegation. LPA Jensen met with Angela Chicas who advised the Licensee/Administrator is out of town and unanavailble. Angela Chicas advised she is the designee in the Administrator's absence.
LPA requested the records for Resident 1 (R1). LPA Jensen was only provided a hospice binder. LPA Jensen spoke to the Licensee by telephone and she confirmed that only the hospice records are available and the attorney was sent what records were available. Based on an interview with the Licensee all available records sent upon request and the "staff did not provide resident's authorized person copies of resident's records is UNSUBSTANTIATED. A finding of unsubstantiated means that although the allegation may have happened, the preonderance of evidence does not prove it. A seperate case management will be conducted for a lack of required records. An exit interview was conducted and a copy of this report and appeal rights were provided.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction