Complaint Investigation Report

515000683-3-23-2023-25-AS-KHOS-CQSLWP-20230411090729

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO NORTH ASC , 2525 NATOMAS PARK DR STE 270

This is an official report of an unannounced visit/investigation of a complaint received in our office on

01/09/2023 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 25-AS-20230109160715

Staff caused a resident to fall while in care

LPA Hiratsuka, conducted this unnanounced complaint visit to deliver the findings of the allegation above.

LPA interviewed staff and the resident in question. LPA also reviewed the incident report and resident's file. Resident stated the facility staff put an onxygen tank in the middle of the floor and the resident tripped on it. The staff stated they found the resident in the bathroom on floor with no oxygen tank around.

LPA cannot prove or disprove the allegation because each side has their own version of events.

Due to the information gathered, LPA cannot determine the Staff caused a resident to fall while in care. LPA finds allegation to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are unsubstantiated.