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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 052700992
Report Date: 08/20/2026
Date Signed: 08/20/2026 09:32:13 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
02/05/2026 and conducted by Evaluator Jason Lund
COMPLAINT CONTROL NUMBER: 27-AS-20260205082556
FACILITY NAME:FOOTHILL VILLAGE SENIOR LIVINGFACILITY NUMBER:
052700992
ADMINISTRATOR:JACOB HARRYMANFACILITY TYPE:
740
ADDRESS:1400 FOOTHILL VILLAGE DRIVETELEPHONE:
(805) 801-0404
CITY:ANGELS CAMPSTATE: CAZIP CODE:
95222
CAPACITY:78CENSUS: 73DATE:
08/20/2026
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Excutive Director Viridiana Ortiz Rangel TIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not meet the resident's toileting care needs

Staff did not provide proper supervision to resident in care

Staff did not provide proper food service to resident in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jason Lund arrived unannounced to this facility to deliver complaint findings. LPA Lund met with Excutive Director Viridiana Ortiz Rangel and explained the purpose of the visit. Census 73

Staff did not meet the resident's toileting care needs- LPA Lund reviewed facility paperwork, interviewed reporting party, staff, and witness. Based on reviewed facility paperwork, interviews with staff, reporting party, and witness. LPA Lund reviewed hourly bathroom charts for Resident (R1) from 2/5/2026 from 5/26/2026 which states that staff did hourly checks on R1 to see if R1 is wet or dry. Staff interviewed stated that they would do hourly checks on R1 to see if R1 was wet or not. Reporting Party and witness stated that R1”s toileting care needs are being met.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026
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 2
Control Number 27-AS-20260205082556
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: FOOTHILL VILLAGE SENIOR LIVING
FACILITY NUMBER: 052700992
VISIT DATE: 08/20/2026
NARRATIVE
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Based on reviewed facility paperwork, interviews with staff, reporting party, and witness, on the information provided, it was unclear if staff did not meet the resident's toileting care needs, therefore the allegation was deemed UNSUBSTANTIATED.

Staff did not provide proper supervision to resident in care- LPA Lund reviewed facility paperwork, interviewed reporting party, staff, and witness. Based on reviewed facility paperwork, interviews with staff, reporting party, and witness. LPA Lund reviewed hourly bathroom charts for Resident (R1) from 2/5/2026 from 5/26/2026 which states that staff did hourly checks on R1. Staff interviewed stated that they would do hourly checks on R1. Reporting Party and witness stated that the facility is providing supervision to R1.

Based on reviewed facility paperwork, interviews with staff, reporting party, and witness, on the information provided, it was unclear if staff did not provide proper supervision to resident in care, therefore the allegation was deemed UNSUBSTANTIATED.

Staff did not provide proper food service to resident in care- LPA Lund reviewed facility paperwork, interviewed reporting party, staff, and witness. Based on reviewed facility paperwork, interviews with staff, reporting party, and witness. LPA Lund reviewed meal tracking form from 4/2/2026 through 5/25/2026 for Resident (R1) which would state if R1 would eat or not. Reporting Party and witness stated that R1 needs including meals are being met from the facility.

Based on reviewed facility paperwork, interviews with staff, reporting party, and witness, on the information provided, it was unclear if staff did not provide proper food service to resident in care, therefore the allegation was deemed UNSUBSTANTIATED.

As a result of this investigation, this Department finds the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated 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. Exit interview conducted and report left.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026
LIC9099 (FAS) - (06/04)
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