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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701212
Report Date: 08/22/2025
Date Signed: 08/22/2025 03:53:43 PM

Unfounded


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
05/09/2025 and conducted by Evaluator Noel Wolf Petersen
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250509144019
FACILITY NAME:CARLTON SENIOR LIVING SACRAMENTO ATRIUMFACILITY NUMBER:
342701212
ADMINISTRATOR:KASIE WIMMERFACILITY TYPE:
740
ADDRESS:1071 FULTON AVENUETELEPHONE:
(916) 971-4800
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:99CENSUS: 50DATE:
08/22/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Kasie Wimmer and Cal MendiolaTIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff required resident's authorized representative to sign admission documents that interfered with resident's personal rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/22/25 at 8:45am, Licensing Program Analyst(LPA) Noel Wolf Petersen and Licensing Program Manager (LPM) Liza King arrived to conduct a complaint investigation, LPA and LPM met with executive director Kasie Wimmer to explain the purpose of the visit.

The above allegation was investigated by Record review. The Admission agreement appendix Ahas a clause number 11 that states in paraphrase, that the arbitration agreement segment is volluntary and not a condition of admission or care to the facility. LPA gave the guidance that the volluntary element should be more promenently displayed, but it is not out of compliance. This agency has investigated the complaint and found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/ or is without a reasonable basis.”

An exit interview was conducted, the report was read a copy of the report and appeal rights was given to the Executive Director.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2025
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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