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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 10/17/2025
Date Signed: 10/17/2025 03:30:57 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
03/26/2025 and conducted by Evaluator Pang Lee
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250326150306
FACILITY NAME:APPLE RIDGE ASSISTED LIVING, LLCFACILITY NUMBER:
342701251
ADMINISTRATOR:WHITE, CHARLESFACILITY TYPE:
740
ADDRESS:3950 ANNADALE LANETELEPHONE:
(916) 489-6900
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:94CENSUS: 82DATE:
10/17/2025
UNANNOUNCEDTIME BEGAN:
12:09 PM
MET WITH:Ilona CorpusTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Staff did not seek timely medical attention for residents
Staff are not meeting residents’ personal hygiene needs
INVESTIGATION FINDINGS:
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On 10/17/2025, Licensing Program Analyst (LPA) Pang Lee arrived unannounced to this facility to conduct a complaint visit. PA Lee met with the Executive Director Ilona Corpus and explained the purpose of the visit. The purpose of this visit is to deliver complaint finding for the above allegation. The current census is82. A brief interview conducted with Executive Director Corpus.

It was alleged that staff did not seek timely medical attention for residents. The investigation was conducted, including a review of relevant documentation, interviews with facility staff, residents in care and the residents’ Responsible Party (RP). Throughout the investigation it was learned that on 02/17/2025, resident 1 (R1) experienced a fall and was transported to the hospital for evaluation. The discharge diagnosis noted eyebrow abrasion, and discharge instructions advised a follow-up with the primary care provider (PCP) within one week.

CONTINUED LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025
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-20250326150306
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: 10/17/2025
NARRATIVE
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On 03/25/2025, R1 sustained another fall, and again received emergency medical attention. Hospital discharge instructions recommended follow-up care with a PCP or orthopedic specialist. While follow-up appointments were recommended in both instances, records confirmed that R1 did not attend the follow-up visits. Interviews and records revealed that R1 has a Durable Power of Attorney for Health Care and Finances, executed on 08/13/2022, which grants the RP full authority over R1’s healthcare decisions. The facility did notify R1’s responsible party of both incidents. In a statement, RP stated that RP resides out of state and acknowledged being unable to arrange follow-up care, despite being aware of their legal authority and responsibility and was notified of the incidents. In an interview with 4 out of 4 facility staff all denied that R1 staff did not seek timely medical attention to R1. In an interview with 7 out of 7 residents who all stated no concerns with facility staff, not providing timely medical attention to residents in care. Additionally, R1’s responsible party expressed no concerns about the care being provided and stated that the facility staff are doing their best. Based on interviews and records review during the investigation process LPA Lee was unable to corroborate the allegation.

It was alleged that staff are not meeting residents’ personal hygiene needs. The investigation included observations, record reviews, and interviews with staff, residents in care and a resident’s responsible party. During facility visits on 07/10/2025 and 10/03/2025, LPA Lee observed residents in the memory care unit to be groomed, with no signs of unmet personal hygiene needs. Review of R1’s chart notes and shower logs indicated that activities of daily living (ADLs), including showering and dressing, were being completed despite R1 exhibiting agitation and violent behavior. Moreover, R1 were sent to the hospital on 02/06/2025 due to anxiety and were discharged with a diagnosis of behavioral disturbance. Documentation revealed that R1 occasionally refused showers and being changed. Three staff interviews indicated that R1’s personal hygiene care was being provided, although care was brief due to R1’s agitation and aggression and that R1 occasionally refused showers and being changed. Interviews with 7 out of 7 residents who stated no concerns about their personal hygiene’s needs not being met by facility staff. Moreover, in an interview with R2’s responsible party who occasionally visits R2 has no concern with their family member’s personal hygiene needs not being met. Additionally, R1’s responsible party expressed no concerns about the care being provided and stated that the facility staff are doing their best. Based on interviews and records review during the investigation process LPA Lee was unable to corroborate the allegation.

The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation(s)occurred.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025
LIC9099 (FAS) - (06/04)
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