342700471-12-29-2025-59-AS-LMUZ-DPUSUW-20251230131146

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700471
Report Date: 12/29/2025
Date Signed: 12/29/2025 01:16:33 PM

Substantiated

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
04/14/2025 and conducted by Evaluator Cheyenne Ratajczak

COMPLAINT CONTROL NUMBER: 59-AS-20250414151432

FACILITY NAME:	COGIR OF STOCK RANCH		FACILITY NUMBER:	342700471
ADMINISTRATOR:	DAVID JR., RICKY		FACILITY TYPE:	740
ADDRESS:	7418 STOCK RANCH RD		TELEPHONE:	(916) 725-7418
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95621
CAPACITY:	99	CENSUS: 72	DATE:	12/29/2025
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Ricky David		TIME COMPLETED:	01:25 PM

ALLEGATION(S):

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Staff are mismanaging residents' medication

INVESTIGATION FINDINGS:

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13

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

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

LIC9099 (FAS) - (06/04)

Page: 1 of 7

Control Number 59-AS-20250414151432

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: COGIR OF STOCK RANCH	FACILITY NUMBER: 342700471
	VISIT DATE: 12/29/2025

NARRATIVE

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Allegation: Staff are mismanaging residents' medication-Substantiated 
On 05/01/2025 LPA Ratajczak and LPM Munoz conducted a medication audit for five (5) residents. During the medication audit, the following was found:
Resident #5 (R5)
Discontinued order for Baclofen on 04/25/25. LPM and LPA observed medication to still be in the medication cart.
Resident #6 (R6)
Discontinued order for Aspirin on 04/29/25; for Breztru inhaler on 04/29/25 and for PreserVision AREDS on 04/15/2025. It was observed that all discontinued medications were in the medication cart.
R6 had an order for Norco on 03/16/2025, the medication was not ordered and not in facility.
Resident #7 (R7)
Discontinued order for Midodrine on 04/24/25. LPM and LPA observed medication to still be in the medication cart.

Based on information obtained, the allegation is found to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

Exit interview conducted a copy of the report provided and appeal rights provided.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20250414151432

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: COGIR OF STOCK RANCH	FACILITY NUMBER: 342700471
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/29/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/12/2026 Section Cited CCR 87465(a)(4)	1 2 3 4 5 6 7	87465 Incidental Medical and Dental Care(a) A plan for incidental medical and dental care shall be developed by each facility. ...(4) The licensee shall assist residents with self-administered medications as needed. This poses a potential risk to health and safety for residents in care.	1 2 3 4 5 6 7	Licensee is to conduct a medication audit and submit findings to the Department. Additionally, licensee will come up with a plan on how the facility will ensure all discontinued medications discarded timely as well as submit a training plan on how staff are trained to discard and document discontinued medications.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: Based on medication audit, facility is retaining residents discontinued medication and ordered medications are not in the facility.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 7

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
04/14/2025 and conducted by Evaluator Cheyenne Ratajczak

COMPLAINT CONTROL NUMBER: 59-AS-20250414151432

FACILITY NAME:	COGIR OF STOCK RANCH		FACILITY NUMBER:	342700471
ADMINISTRATOR:	DAVID JR., RICKY		FACILITY TYPE:	740
ADDRESS:	7418 STOCK RANCH RD		TELEPHONE:	(916) 725-7418
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95621
CAPACITY:	99	CENSUS: 72	DATE:	12/29/2025
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Ricky David		TIME COMPLETED:	01:25 PM

ALLEGATION(S):

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Staff are falsifying medication administration records

INVESTIGATION FINDINGS:

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On 12/29/2025, Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to deliver final findings to a complaint Community Care Licensing (CCL) received on 04/14/2025. LPA met with Executive Director (ED) Ricky David and explained the purpose of the visit.
During the course of the investigation, the Department conducted interviews and record review.
Allegation: Staff are falsifying medication administration records- Unsubstantiated 
The facility uses an EMAR system to input medications given. In the system, staff are able to input if a resident refuses medication, if a medication needs to be reordered, if a medication is discontinued, or if a doctor has a medication on hold. There was no specific information regarding which resident or EMARs might or might not have been falsified.
Based on this information, these allegations are UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are unsubstantiated.  
Exit interview conducted and a copy of the report and appeal rights provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

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

LIC9099 (FAS) - (06/04)

Page: 4 of 7

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
04/14/2025 and conducted by Evaluator Cheyenne Ratajczak

COMPLAINT CONTROL NUMBER: 59-AS-20250414151432

FACILITY NAME:	COGIR OF STOCK RANCH		FACILITY NUMBER:	342700471
ADMINISTRATOR:	DAVID JR., RICKY		FACILITY TYPE:	740
ADDRESS:	7418 STOCK RANCH RD		TELEPHONE:	(916) 725-7418
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95621
CAPACITY:	99	CENSUS: 72	DATE:	12/29/2025
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Ricky David		TIME COMPLETED:	01:25 PM

ALLEGATION(S):

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Staff do not ensure residents' showering needs are being met
Staff do not ensure residents’ incontinence needs are being met
Staff are not repositioning resident as needed
Staff did not prevent resident from developing a pressure injury
Staff do not ensure residents' hygiene needs are being met
Staff do not ensure that resident has clean bedding
Staff do ensure resident rooms are clean and sanitary

INVESTIGATION FINDINGS:

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Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

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

LIC9099 (FAS) - (06/04)

Page: 5 of 7

Control Number 59-AS-20250414151432

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: COGIR OF STOCK RANCH	FACILITY NUMBER: 342700471
	VISIT DATE: 12/29/2025

NARRATIVE

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Allegation: Staff do not ensure residents' showering needs are being met- Unfounded
Interviews revealed that residents receive their showers as scheduled. Sometimes showers are moved around but the shower is usually pushed back to the next shift. If a resident is not feeling well, they will ask staff to come back at a later time or to be moved to another day. Resident interviews revealed that some have hospice come in and give them showers also.

Allegation: Staff do not ensure residents’ incontinence needs are being met-Unfounded
Interviews revealed that staff check on residents every one to two hours for incontinence care needs. Depending on residents care needs, they may be checked more than every two hours. Residents will also push their pendants if they need any assistances between checks and staff respond.

Allegation: Staff are not repositioning resident as needed- Unfounded
The department conducted interviews with residents and staff regarding this allegation. Interviews with staff revealed that they reposition residents every two hours unless care plans specify otherwise. Resident interviews revealed that they have staff that come in and reposition them throughout the day.

Allegation: Staff did not prevent resident from developing a pressure injury-Unfounded
Interviews with residents revealed they currently do not have any pressure injuries or if they do they are being treated by hospice. Staff interviews revealed that those who do have a pressure injury they are already being treated by hospice.

Allegation: Staff do not ensure residents' hygiene needs are being met-Unfounded
Interviews with staff revealed that a resident’s care needs are documented on their care plan. Staff assist resident’s with hygiene needs based on a resident’s care plan and the resident’s preference.

Allegation: Staff do not ensure that resident has clean bedding- Unfounded
Interviews revealed that housekeeping will clean the bedding on the day the resident’s room is cleaned. In between that time care staff will observe to see if the sheets need to be changed in-between. If bedding needs to be changed, caregivers will change the bedding.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

Page: 6 of 7

Control Number 59-AS-20250414151432

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: COGIR OF STOCK RANCH	FACILITY NUMBER: 342700471
	VISIT DATE: 12/29/2025

NARRATIVE

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Allegation: Staff do ensure resident rooms are clean and sanitary-Unfounded
Housekeeping cleans the resident’s rooms once a week. In between that time if some additional cleaning is needed caregivers will assist. LPA observed nine (9) residents bedrooms. All rooms were observed to be clean and sanitary. Some residents do have animals. Those animals are the residents responsibility and to clean up after them if they are to go in their rooms. Residents who can no longer care for their animals families will hire outside help to come in and care for the animal. Interviews revealed that staff will clean up the animal feces if they see it when they are in the rooms.

Based on information obtained through interviews, the Department finds the allegation to be UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.  

Exit interview conducted and a copy of the report was left at the facility. 

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

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