315920037-7-8-2025-59-AS-KHOS-DJKNTF-20250714104441

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 315920037
Report Date: 07/08/2025
Date Signed: 07/08/2025 04:16:31 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/15/2025 and conducted by Evaluator Kevin Mknelly

COMPLAINT CONTROL NUMBER: 59-AS-20250515100934

FACILITY NAME:	SAPPHIRE SENIOR CARE		FACILITY NUMBER:	315920037
ADMINISTRATOR:	TULENINOVA, NATALIA		FACILITY TYPE:	740
ADDRESS:	667 GRIDER DRIVE		TELEPHONE:	(279) 900-8903
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	6	CENSUS: 6	DATE:	07/08/2025
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Natalia Tuleninova		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Facility was not kept free of pests
Staff did not treat residents with respect
Facility was not kept free of mold
Staff is not able to communicate with residents

INVESTIGATION FINDINGS:

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On 7/8/25, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with xxx xxx.

LPA conducted records review and extensive interviews.
LPA is unable to find and or meet the preponderance, per policy.

During inspections no pests were observed and Administrator denied that there has ever been a pest problem.
Residents interviewed stated they had not recalled having been spoken to harshly.
Mold was not observed by LPA to be present on surfaces.
During past and recent inspections, LPA observed staff to have adequate language proficiency to communicate with residents.

As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview with administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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