Complaint Investigation Report

502701433-7-10-2025-27-AS-KHOS-DJKKKU-20250714075855

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

03/05/2025 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20250305161401

Facility staff mismanaged resident's medications.

On 07/10/2025, Licensing Program Analyst (LPA) Renee Campbell went to the Safe Haven Oakdale LLC residential home for the elderly to deliver a complaint that was filed with the department on 3/5/2025:

Facility staff mismanaged residents’ medication

Based on a review of the MAR report and interview with S1, the allegation could not be substantiated as there was no indication that medication had been shared with another resident and S1 denied sharing a resident’s medication with other residents. 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, therefore the allegation is UNSUBSTANTIATED.

There are no deficiencies noted or cited per California Code Regulation.

An exit interview was conducted with the House Manager Appeal Rights were issued, and a copy of this report was left at the facilit