345920401-2-13-2026-59-AS-MSEY-DREM9V-20260218082520

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345920401
Report Date: 02/13/2026
Date Signed: 02/13/2026 12:29:11 PM

Unfounded

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
02/12/2026 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20260212084109

FACILITY NAME:	ELIM COURTE		FACILITY NUMBER:	345920401
ADMINISTRATOR:	CUCCIA, FARAH		FACILITY TYPE:	740
ADDRESS:	6825 SUNRISE BLVD		TELEPHONE:	(916) 305-5325
CITY:	CITRUS HEITHS	STATE: CA	ZIP CODE:	95610
CAPACITY:	48	CENSUS: 29	DATE:	02/13/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Brenda Cobos, Administrator and Jennifer Lee, VP		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff are not properly trained.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabrina Calzada, arrived unannounced to conduct a 10-day inspection for a complaint received February 12, 2026. LPA initially met with Brenda Cobos, Administrator and then with Jennifer Lee, VP, and stated the reason for today's inspection.

During today's inspection, LPA discussed the allegation with both managers and reviewed documentation related to a resident who was under hospice care prior to recently passing. LPA also toured the interior and exterior of the community and observed many residents to be engaged in the activity area.

The results of the investigation are as follows:

*cont on 9099C-1..

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026

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 59-AS-20260212084109

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: ELIM COURTE	FACILITY NUMBER: 345920401
	VISIT DATE: 02/13/2026

NARRATIVE

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9099C-1.. Allegation: Staff are not properly trained. The allegation states that during the NOC shift from Saturday, February 7, 2025 to Sunday, February 8, 2026, one resident needing Morphine to be administered on a PRN basis, were left around midnight with only (2) caregivers who have no knowledge of emergency situations and were not Med-Techs or nurses. The allegation also states these caregivers were left with Medication Room keys that include keys to Narcotic medication for specific residents.

The administrator stated that there were (27) residents in the building during this NOC shift, and the scheduled Med-Tech became ill with flu type symptoms around 11:00 pm. The corporate officers arrived around 11:30 pm and counted the Narcotic medication with the Med-Tech, before leaving their shift due to being ill. The administrator further commented that there are currently no residents with medications scheduled during the NOC shift and that no PRN medications were requested or given either.

The corporate Vice-President stated that she was at the building all day, on Saturday, February 7, 2026, beginning at 5:00 am, due to discovering the Wi-Fi was down, and confirmed that she remained at the community until around 6:00 pm, before taking a meal break. After leaving the community, she was continually checking if the coverage was adequate and returned around 10:20 pm, to assist staff with checking on residents, who were all observed to be calm. After leaving the building for a break nearby, the officer stated she returned with another corporate officer around 11:30 pm, after being informed the scheduled Med-Tech became ill. There were two caregivers who remained on site after midnight to complete their scheduled shift; however, the corporate officers remained on call, if needed, to administer any medications.

LPA reviewed documentation that medications were counted and confirmed by (2) trained staff at each shift change on February 7, 2026 and February 8, 2026, and there were no narcotics missing. Additionally, neither caregiver entered the Medication Room during this shift.

LPA reviewed medication documentation for resident (R1) who passed under hospice care on February 9, 2026. The documentation shows that (R1) had a prescription for Morphine Sulf IR 15 mg- 1 tablet every 4 hours, as needed for pain, or shortness of breath, and was administered (3) dosages on February 2, 2026, (2) dosages on February 3, 2026, (1) dosage on February 4, 2026 and a final dosage on February 9, 2026 (1:56 pm), prior to passing. Additionally, (R1) was administered (2) dosages of Lorazepam 0.5mg on February 2, 2026, as prescribed for agitation. *cont on 9099C-2..

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20260212084109

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: ELIM COURTE	FACILITY NUMBER: 345920401
	VISIT DATE: 02/13/2026

NARRATIVE

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9099C-2.. Additionally, the VP stated that the hospice nurse had just visited (R1) earlier in the afternoon on February 9, 2026, prior to (R1) passing and returned at that time to confirm (R1's) death. (R1's) family had visited during the day on February 9, 2026 and conveyed to the VP that (R1) was very comfortable.

The administrator and VP confirmed that (S1) and (S2) are seasoned employees and have completed required training through an approved vendor.

Based on information obtained, LPA finds the allegation to be A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026

LIC9099 (FAS) - (06/04)

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