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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347004346
Report Date: 07/23/2025
Date Signed: 07/23/2025 04:44:44 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
05/19/2025 and conducted by Evaluator Angela Hood
COMPLAINT CONTROL NUMBER: 59-AS-20250519104944
FACILITY NAME:SUNRISE ASSISTED LIVING OF CARMICHAELFACILITY NUMBER:
347004346
ADMINISTRATOR:TANIA LANGLANDFACILITY TYPE:
740
ADDRESS:5451 FAIR OAKS BLVDTELEPHONE:
(916) 485-4500
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:66CENSUS: 40DATE:
07/23/2025
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Jessica Sanders, Executive DirectorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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-Staff did not address residents lice infestation
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angela Hood arrived at the care home today and met with the Executive Director (ED), Jessica Sanders, to deliver complaint investigation findings regarding the above stated allegation.

During the course of the investigation, LPA conducted interviews, made observations, and obtained documentation pertinent to the investigation. Interviews with the ED, Resident Care Director (RCD), Memory Care Director (MCD), and staff (S1, S2, and S4) indicated that resident (R1) was observed on May 16, 2025 to have what appeared to be fleas in their hair. R1 had a pet cat in their apartment. R1's progress notes indicated that their responsible party and the primary care physician's (PCP) office were notified. Interviews with ED, RCD, MCD, S1, S2, and S4 indicated that on May 17, 2025 it was determined by the facility nurse that R1 had head lice. Interviews with ED, RCD, MCD, S1, S2, and S4 indicated that other residents were checked for head lice and were not observed to have lice. The facility received medical orders on
************************************************Continued on LIC9099-C**************************************************
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
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 59-AS-20250519104944
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: SUNRISE ASSISTED LIVING OF CARMICHAEL
FACILITY NUMBER: 347004346
VISIT DATE: 07/23/2025
NARRATIVE
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May 17, 2025, May 18, 2025, and May 20, 2025 to provide R1 with lice elimination treatments to their hair. According to R1's progress notes and email correspondence between the ED and RCD, R1 received lice elimination treatments to their hair on May 17, 2025, May 18, 2025, and May 22, 2025. On May 21, 2025, with the assistance of S1, LPA observed R1's head and did not observe any active lice; however, did appear as though there may be a few eggs remaining. Facility staff agreed to complete an additional treatment. LPA did not observe any fleas, lice, or other pests in R1's room. R1's progress notes indicated that on May 22, 2025, R1 had "3 head lice treatments given with no traceable lice now". Progress notes and interviews with facility staff indicated that R1's room was cleaned on May 17, 2025. Interview with Maintenance Director indicated that they completed a deep cleaning of R1's room on May 22, 2025 using a lice treatment. Maintenance Director provided LPA a receipt for the lice treatment purchased on May 22, 2025. LPA was unable to observe R1 on a second occasion as R1 moved out of the facility on May 31, 2025.

Based on interviews conducted, documentation reviewed, and observations, the above allegation is found to be UNFOUNDED. 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. No deficiencies are being cited.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
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