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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700867
Report Date: 05/29/2025
Date Signed: 05/29/2025 04:04:49 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
03/04/2025 and conducted by Evaluator Michael Hood
COMPLAINT CONTROL NUMBER: 59-AS-20250304163306
FACILITY NAME:ALC ASSISTED LIVING INC.FACILITY NUMBER:
342700867
ADMINISTRATOR:LITA, JOHN D.FACILITY TYPE:
740
ADDRESS:6705 JUDISTINE DRIVETELEPHONE:
(916) 844-7052
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:6CENSUS: 5DATE:
05/29/2025
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Ruth Lita, House ManagerTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff interfered with resident’s visits.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with House Manager, Ruth Lita, to deliver findings for the complaint allegation listed above.

During the investigation, LPA toured the facility, conducted interviews, and reviewed documentation pertinent to the investigation. The results of the investigation are as follows:

Allegation: Staff interfered with resident’s visits.

Relevant party reported to the Department that they have only be able to visit a resident three (3) times at the facility due to the facility requiring an appointment and advance notice for visits. Relevant party reports that they have been prevented from entering the home by staff member (S1).

** Report continued on 9099-C **
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
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 8
Control Number 59-AS-20250304163306
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: ALC ASSISTED LIVING INC.
FACILITY NUMBER: 342700867
VISIT DATE: 05/29/2025
NARRATIVE
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LPA arrived at the facility on March 6, 2025 to open complaint. LPA was refused entry of the home by S1 after LPA provided proper identification and stated the purpose of their visit. LPA was eventually provided entry of home by House Manager on March 6, 2025. LPA provided technical support regarding inspection authority during visit.

Interviews with staff members S1, S2, and Licensee, Jeanina Lita, indicated that visiting hours at the facility are from 10:00 AM to 4:00 PM. Interview with Licensee indicated that, if the visitor is not someone the facility staff know, they may consult with the family to confirm whether the resident knows the visitor before facilitating visitation. LPA discussed with LIcensee PIN 25-04-ASC, which states "Third parties, such as court-appointed conservators and agents under powers of attorney generally may not curtail a resident’s right to have visitors, confidential telephone calls, and personal mail unless they have explicit authority to do so."

Licensee stated that, if a visitor arrives at the facility outside of visiting hours, S1 will call Licensee and inform the visitor of visiting hours. Licensee stated that the facility has accommodated visitors outside of visiting hours. Interview with S1 indicated that that S1 will not allow visitors inside the facility if they arrive on the premises outside of visiting hours. S1 stated that they will answer the door outside of visiting hours, but they will not let the individual inside the facility. S1 stated that they "are willing" to provide Licensee's phone number to visitors if they arrive outside of visiting hours.

LPA reviewed Visitor Policy Addendum that is signed by residents as part of their Admission Agreement, which states "We want our residents to have visitors, but also take everyone's safety and comfort seriously- As such, our visiting hours are from 10:00 AM to 4:00 PM by appointment only. We require 24-hour notice for a visitation along with approval by our administrative staff. We reserve the right to deny a visitation if prior scheduling was not made. We also reserve the right to deny any appointment if it interferes with prescheduled activities of other residents. A second option for visitation is to have a set recurring time for visitation, this allows staff to be aware of visitation and plan facility activities accordingly. Failure to comply by this house rule will lead to termination of lease agreement."

** Report continued on 9099-C **
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 8
Control Number 59-AS-20250304163306
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: ALC ASSISTED LIVING INC.
FACILITY NUMBER: 342700867
VISIT DATE: 05/29/2025
NARRATIVE
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Based on LPA's observations, interviews conducted, and records reviewed, the preponderance of evidence standards have been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D page.

Exit interview was conducted. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 8
Control Number 59-AS-20250304163306
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: ALC ASSISTED LIVING INC.
FACILITY NUMBER: 342700867
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/13/2025
Section Cited
CCR
87468.1(a)(11)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (11) To have their visitors, including ombudspersons and advocacy representatives, permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon. This requirement is not met as evidenced by:
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Facility will update Visitor Policy in accordance with Title 22 and have residents and/or their responsible parties review and sign updated policy to add to their Admission Agreement. Facility will also create a plan on ensuring visiation for residents.
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Based on observations, interviews conducted, and records reviewed, the facility did not ensure to facilitate visitation for residents in accordance with Title 22, which poses a potential health, safety, and/or personal rights risk to the residents in care.
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Facility will submit signed visitor policies and plan to LPA by POC due date.
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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: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 8
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
03/04/2025 and conducted by Evaluator Michael Hood
COMPLAINT CONTROL NUMBER: 59-AS-20250304163306

FACILITY NAME:ALC ASSISTED LIVING INC.FACILITY NUMBER:
342700867
ADMINISTRATOR:LITA, JOHN D.FACILITY TYPE:
740
ADDRESS:6705 JUDISTINE DRIVETELEPHONE:
(916) 844-7052
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:6CENSUS: 5DATE:
05/29/2025
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Ruth Lita, House ManagerTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff did not assist resident with bathing as needed.

Staff neglect resulted in a resident sustaining a pressure injury.

Staff did not ensure resident’s room was adequately cleaned.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with House Manager, Ruth Lita, to deliver findings for the complaint allegations listed above.

During the investigation, LPA toured the premises, conducted interviews, and reviewed documentation pertinent to the investigation. The results of the investigation are as follows:

Allegation: Staff did not assist resident with bathing as needed.

Relevant party reported to the Department that resident (R1) had reported not being showered in months.

** Report continued on 9099-C **
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
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 8
Control Number 59-AS-20250304163306
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: ALC ASSISTED LIVING INC.
FACILITY NUMBER: 342700867
VISIT DATE: 05/29/2025
NARRATIVE
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Multiple interviews with R1 indicated that they feel that their care needs are being met at the facility and they have no concerns regarding the facility. R1 stated that they are treated well by facility staff. LPA observed R1 during multiple visits, including March 6, 2025, April 9, 2025, and May 28, 2025, and observed that R1 was clean and receiving care. Interview with Witness (W1) indicated that R1 receives good assistance with care. W1 stated that R1 is well taken care of, including hygiene assistance.

Interviews with multiple representatives of R1's hospice agency indicated that they had no concerns regarding hygiene assistance provided by facility staff for R1. Interviews with Licensee and staff members S1 and S2 indicated that they have never witnessed a resident in need of showering or incontinence care at the facility and not receiving assistance from care staff. Interview with resident (R2) indicated that they feel that their care needs are being met at the facility and they're treated well by facility staff. R2 stated that staff do a good job providing care and providing hygiene assistance. Interview with resident (R3) indicated that they are doing "OK."

Allegation: Staff neglect resulted in a resident sustaining a pressure injury.

Interview with R1 indicated that they have a couple of pressure sores on their "behind." Interviews with Licensee, S1, and S2 indicated that R1's pressure injuries are managed by nurses from hospice agency. Licensee and S2 stated that R1 was receiving Home Health services prior to admission to Hospice who were providing assistance with R1's wounds. Licensee and S2 stated that, since R1 was admitted to the facility, R1 has either been receiving services from Home Health or Hospice.

Interviews with W1 and multiple representatives of R1's hospice agency indicated that they have not observed any neglect from facility care staff with assistance regarding R1's pressure injuries. Interview with Hospice representative indicated that R1's pressure injuries are managed by R1's hospice agency.

** Report continued on 9099-C **
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 8
Control Number 59-AS-20250304163306
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: ALC ASSISTED LIVING INC.
FACILITY NUMBER: 342700867
VISIT DATE: 05/29/2025
NARRATIVE
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Hospice representative indicated that R1 has pressure injuries on their right great toe that is half a centimeter by half a centimeter and stage 2, on their left toe that is half a centimeter by half a centimeter and stage 2, and the plantar area of the left foot that is stage 2 and improving. Hospice representative stated that pressure injuries require dressing two (2) to three (3) times a week. Hospice representative stated that R1 has a stage 2 wound on their buttocks that is "off and on." Hospice representative stated that wound on buttocks is currently healed and a little red. Hospice representative stated that repositioning would assist with wound on buttocks but R1 often does no comply with repositioning. Hospice representative stated that R1 has purple vascular disease as their primary diagnosis along with diabetes and a history of osteomyelitis. Hospice representative stated that R1 has had to have toes amputated on both feet. Hospice representative stated that R1 has neuropathy in their legs and doesn't have good sensation in feet. Hospice representative stated that facility attempted to use a hoyer lift for R1 but R1 could not tolerate sitting up because of dizziness and hypertension. Hospice representative stated that R1 didn't want to get up anymore because it was uncomfortable and doesn't want to use the hoyer lift. Hospice representative stated that R1 was admitted to hospice with more wounds than present. Hospice representative stated that, when admitted on October 21, 2024, R1 had pressure wounds to both calves, with right calf being stage 2, as well as left buttocks. Hospice representative stated that previous wounds have healed since R1 was admitted to hospice. Hospice representative stated there is no evidence of previous pressure wounds. LPA reviewed R1's hospice records. LPA observed that information obtained from R1's hospice records coincide with statement provided to LPA by Hospice representative.

Allegation: Staff did not ensure resident’s room was adequately cleaned.

Relevant party reported to the Department that they observed R1's room to be unclean. Interview with R1 indicated that they feel that their room is clean and staff are good about cleaning at the facility. LPA observed R1's room during multiple visits, including March 6, 2025, April 9, 2025, and May 28, 2025, and did not observe R1's room to be unclean or malodorous.

** Report continued on 9099-C **
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 59-AS-20250304163306
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: ALC ASSISTED LIVING INC.
FACILITY NUMBER: 342700867
VISIT DATE: 05/29/2025
NARRATIVE
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Interviews with Licensee, S1, S2, R2, W1, and multiple representatives of R1's hospice agency indicated that they have never witnessed anywhere in the facility be unclean or in disrepair.

Based on interviews conducted, observations, and records reviewed, the preponderance of evidence standards have not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation 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 was conducted. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2025
LIC9099 (FAS) - (06/04)
Page: 8 of 8