Complaint Investigation Report

585000698-5-5-2023-59-AS-LMUZ-CRK4J6-20230505190812

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

03/21/2023 and conducted by Evaluator Melissa Parks

COMPLAINT CONTROL NUMBER: 59-AS-20230321152737

Staff did not notify residents family of residents death.

On Friday May 5, 2023, Licensing Program Analyst (LPA) Melissa Parks arrived at the facility unannounced to deliver complaint findings into the allegation listed above and met with Health Services Director Sherri.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

Allegation: Staff did not notify residents family of residents death.

Based on interviews conducted and file reviewed, facility notified POA of R1s passing, which meets Title 22 reporting requirements. Therefore, the allegation is unfounded meaning that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview was conducted with Sherri and a copy of this report was provided to the facility.