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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347001498
Report Date: 01/29/2025
Date Signed: 11/04/2025 04:56:30 PM

Substantiated


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
10/14/2024 and conducted by Evaluator Sabrina Calzada
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20241014152140
FACILITY NAME:CITRUS HEIGHTS TERRACEFACILITY NUMBER:
347001498
ADMINISTRATOR:MAGDA LUISFACILITY TYPE:
740
ADDRESS:7952 OLD AUBURN ROADTELEPHONE:
(916) 727-4400
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:49CENSUS: 48DATE:
01/29/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ashley Stahl, Resident Care Coordinator TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff do not safeguard residents' personal property.
INVESTIGATION FINDINGS:
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**This report was amended on November 4,2 2025 due to a citation being dismissed on October 28, 2025. The citation was issued under Regulation 87218(a)(1)- Theft and Loss. The 9099D page is also being amended on November 4, 2025 to show this citation was dismissed. **

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to complete a complaint investigation and deliver findings to a partial complaint received on 10/14/24. LPA met with Ashley Stahl, Resident Care Coordinator, and stated the reason for today's inspection. LPA was advised that the Interim Administrator, Magda Luis, was currently out of the building.

During the course of the investigation, LPA interviewed the Interim Administrator, Resident Care Coordinator, (3) facility staff and a resident's family member. LPA also toured the facility on 10/21/24 and 1/29/25 and reviewed (7) resident files. The results of the investigation are as follows:

The allegation states that resident laundry often goes missing and is not returned to the correct resident's room.

*cont on 9099C-1..
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
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 4
Control Number 59-AS-20241014152140
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: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498
VISIT DATE: 01/29/2025
NARRATIVE
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9099C-1.. A resident's family member stated that not all laundry is returned to their resident's room, even after labeling the clothes. This family member stated that resident was missing a pair of pants and is currently missing a pair of pajamas. Additionally, this family member stated that the roommate of her family member was using their sheets and blankets were also missing. This family member stated they have observed residents wearing clothes, and shoes, that don't match or are ill-fitting.

The Department received a complaint about another resident missing a raincoat, socks and a pair of dentures for a year. The Resident Care Coordinator stated that this resident has numerous jackets in their closet and never had the specific type of sock that was reported to be missing by the conservator. The RCC stated that this resident moved in with dentures in 2022 but has not seen them lately but believes the Conservator may have taken them from the facility. The RCC stated the Conservator is difficult to get in contact with and recently had medical surgery.

LPA reviewed (7) resident files including for both residents referred to in the above paragraphs. In all (7) files reviewed, there was either not a completed LIC621/Client /Resident Personal Property and Valuables on file, or the form was signed by the resident's family member and facility representative as "declining to track personal property" when it was completed at admission.

In the common area near the front entrance is posted the "Resident Personal Property Policies" which states "At the time of admission, the resident is required to complete the form "Client Personal Property and Valuables" (LIC621) and it is signed by the resident, or their representative and the Administrator.

Based on information obtained, the LPA finds the allegation to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following (1) citation is issued on the 9099-D page.

Exit interview with Resident Care Coordinator. Copy of report and appeal rights provided.
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 59-AS-20241014152140
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: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed

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LPA will review resident files at the upcoming annual inspection to ensure all LIC621's have been updated.

**The POC is still outstanding as of November 4, 2025- LPA to check random resident files at a subsequent inspection.
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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.
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4