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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 06/05/2025
Date Signed: 06/05/2025 04:36:56 PM

Unsubstantiated


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
01/08/2025 and conducted by Evaluator Holly Williams
COMPLAINT CONTROL NUMBER: 27-AS-20250108121017
FACILITY NAME:APPLE RIDGE ASSISTED LIVING, LLCFACILITY NUMBER:
342701251
ADMINISTRATOR:CRUZ, ALFREDOFACILITY TYPE:
740
ADDRESS:3950 ANNADALE LANETELEPHONE:
(916) 489-6900
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:94CENSUS: 83DATE:
06/05/2025
UNANNOUNCEDTIME BEGAN:
03:54 PM
MET WITH:Brandon CollinsTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff are not providing residents with snacks
INVESTIGATION FINDINGS:
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On 6/05/25, Licensing Program Analysts (LPAs) Holly Williams and Charlie Yang arrived unannounced to this facility to conduct a complaint visit. LPAs met with Facility Designated Administrator (FDA) Brandon Collins and explained the purpose of the visit. The purpose of this visit was to deliver complaint findings for the allegations above.
Current Census was 83. A brief interview with the FDA was conducted.

Facility is not providing residents with snacks:

During the course of the investigation, LPA interviewed five residents, nine staff, and reviewed the menu with the including snack times. LPA went to the facility three times and the first time on 1/16/25 there were snacks, the second time on 4/8/25 no snacks, and the third time on 4/21/25 there were oranges. Two out of five residents state there are snacks sometimes and then sometimes there are no snacks
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Holly Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
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 2
Control Number 27-AS-20250108121017
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: APPLE RIDGE ASSISTED LIVING, LLC
FACILITY NUMBER: 342701251
VISIT DATE: 06/05/2025
NARRATIVE
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According to the facility menu, snacks are given three times a day at 10:30 AM, 2:30 PM, and 7:30 PM. three out of five residents state snacks are available. R2 states that the facility does have snacks 3 times a day but because the residents hoard the snacks the snacks run out fast. R3 states that she always sees snacks out even in the middle of the night however, they are just Cheezits, and they do not have drinks. Scott states they keep the snacks on the counter in the cafeteria. R5 states that the snacks are given three times a day and they do run out but if there are none if you ask, they will get you a snack. Based on interviews with staff, residents, and LPA observations between meal snacks are available.

Based on interviews, observation, and record review, the above allegation is UNSUBSTANTIATED, which 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.
No deficiencies were cited regarding the above allegation. An exit interview was held, and a copy of this report was left with Brandon Collins.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Holly Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2