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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701040
Report Date: 01/09/2026
Date Signed: 01/09/2026 05:12:41 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
07/24/2025 and conducted by Evaluator Sommer Hayes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250724114324
FACILITY NAME:BRUCEVILLE POINTFACILITY NUMBER:
342701040
ADMINISTRATOR:HOSTETTER, ERICFACILITY TYPE:
740
ADDRESS:9730 BACKER RANCH ROADTELEPHONE:
(916) 226-5300
CITY:ELK GROVESTATE: CAZIP CODE:
95757
CAPACITY:200CENSUS: 134DATE:
01/09/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Marianne RichardsonTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Facility staff did not dispense medications as prescribed
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sommer Hayes and Licensing Program Manager (LPM) Stephen Richardson arrived at the facility to complete a complaint investigation regarding the allegation noted above. LPA and LPM met with Marianne Richardson, Executive Director and stated the purpose of this visit.

LPA and LPM arrived to complete a complaint investigation for an allegation that facility staff failed to dispense medications as prescribed to former resident, Resident 1 (R1). The Reporting Party 1 (RP1) alleged that after the facility assumed responsibility for not administering R1’s medication Levothyroxine for one week, there were ongoing issues with medication availability, timeliness, and staff competency. RP1 reported difficulty obtaining PRN medications, concerns about staff responsiveness, and stated that R1’s laboratory values related to the missed medication, Levothyroxine became significantly elevated during the period of facility medication management.
Continued on 9099C
Substantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Sommer Hayes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
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 3
Control Number 27-AS-20250724114324
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: BRUCEVILLE POINT
FACILITY NUMBER: 342701040
VISIT DATE: 01/09/2026
NARRATIVE
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LPA Hayes reviewed the facility’s Medication Administration Records (MAR) for March 2025 for R1. R1 was prescribed Levothyroxine SOD 0.175 MG, 1 tablet (175 MG) to be given daily at 5:00 AM. In a phone interview on 1/8/2026, with Executive Director (ED), Marianne Richardson, ED confirmed this medication was not given to the R1 on 3/11/2025, due to a medication delivery issue with Omnicare. On 1/9/2026, LPM Richardson reviewed a proof of medication delivery statement from Omnicare which indicates that Levothyroxine was shipped out on 3/10/2025 but was not delivered to the facility until 3/11/2025 at 1:47 PM. Due to the delay in delivering the medication timely to the facility, it caused R1 to not receive their dose of Levothyroxine on 3/11/2025 on time. LPA Hayes also reviewed the Medication Administration Records (MAR) for R1, dated 3/2025, and confirmed that the medication was marked as a missed medication.

LPA Hayes interviewed multiple residents residing at the facility regarding their experiences with medication administration. Three of three residents who participated in the medication management program reported receiving their medications as scheduled and did not report missed, delayed, or incorrect medication administration.

Community Director (DW1) reported that the facility uses an electronic medication administration system. They stated that medications are administered according to physician orders, that medication orders must be entered into the electronic system prior to administration, and that any gaps in medication are reported to the residents’ physician and family.

Based on the review of records, interviews, and facility statements, the investigation determined that R1 did not receive Levothyroxine medication as prescribed on March 11, 2025.

The preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED.

This facility is being cited per Title 22 CCR Section 87465 (a)(4) being cited on the attached LIC 9099D. An exit interview, appeal rights and a copy of this report were left with Marianne Richardson, Executive Director.


SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Sommer Hayes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20250724114324
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: BRUCEVILLE POINT
FACILITY NUMBER: 342701040
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/09/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/10/2026
Section Cited
CCR
87465(a)(4)
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87465 Incidental Medical and Dental Care

(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:
(4) The licensee shall assist residents with self-administered medications as needed.
This requirement was not met as evidenced by:
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Executive Director Marianne Richardson agrees to
We will review our medication delivery process to ensure timely delivery. Retraining with Medication Techs with the fillings of prescriptions.

Email sent to sommer.hayes@dss.ca.gov and stephen.richardson@dss.ca.gov
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Based on interviews and resident records facility staff did not dispense medications as prescribed which poses an immediate health, safety, and/or personal rights risk.
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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: Stephen Richardson
LICENSING EVALUATOR NAME: Sommer Hayes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3