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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 095920119
Report Date: 07/13/2026
Date Signed: 07/13/2026 11:09:34 AM

Unsubstantiated


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
04/13/2026 and conducted by Evaluator Lavinia Muscan
COMPLAINT CONTROL NUMBER: 59-AS-20260413150920
FACILITY NAME:GOLD COUNTRY ASSISTED LIVINGFACILITY NUMBER:
095920119
ADMINISTRATOR:STONE, BONNIEFACILITY TYPE:
740
ADDRESS:4301 GOLDEN CENTER DRIVETELEPHONE:
(530) 621-1100
CITY:PLACERVILLESTATE: CAZIP CODE:
95667
CAPACITY:46CENSUS: 40DATE:
07/13/2026
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Administrator Sandra RiffeyTIME COMPLETED:
11:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff mismanage residents medications.
Staff controls the Resident Council meetings
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 7/13/2026, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator Sandra Riffey.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

**Report continued on 9099-C**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
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 5
Control Number 59-AS-20260413150920
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: GOLD COUNTRY ASSISTED LIVING
FACILITY NUMBER: 095920119
VISIT DATE: 07/13/2026
NARRATIVE
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Staff mismanage residents medications.
Based on documents obtained and statements reviewed for April 2026, the department determined that there was insufficient evidence that any medication errors have occurred. Documents obtained show that all current medications were administered and logged correctly for residents per their doctor’s orders. Five staff interviews (5) indicated that staff were not aware of any medication errors. Based upon the information obtained during investigation, the above allegation is unsubstantiated. A finding that the complaint is 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.

Staff controls the Resident Council meetings
Based on resident interviews, staff interviews, and information obtained during the Department’s investigation, there was insufficient evidence to support the allegation that staff controlled the resident council meetings. Although it was reported that staff appeared to have more involvement and control during resident council meetings several months ago, the process has since changed. The Ombudsman has attended resident council meetings, and residents are currently able to participate, make decisions, and discuss concerns independently without staff involvement for a portion of the meetings. The Department did not obtain sufficient evidence to support that staff are currently controlling resident council meetings. Therefore, this allegation is determined to be unsubstantiated. A finding that the complaint is 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. Report left with facility.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
04/13/2026 and conducted by Evaluator Lavinia Muscan
COMPLAINT CONTROL NUMBER: 59-AS-20260413150920

FACILITY NAME:GOLD COUNTRY ASSISTED LIVINGFACILITY NUMBER:
095920119
ADMINISTRATOR:STONE, BONNIEFACILITY TYPE:
740
ADDRESS:4301 GOLDEN CENTER DRIVETELEPHONE:
(530) 621-1100
CITY:PLACERVILLESTATE: CAZIP CODE:
95667
CAPACITY:46CENSUS: 40DATE:
07/13/2026
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Administrator Sandra RiffeyTIME COMPLETED:
11:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not respond to residents' requests for assistance.
Staff member verbally abuses residents in care.
Staff member emotionally abuses residents in care.
Staff are not adequately trained.
Staff do not provide residents with activities.
Staff did not ensure that toxic substances were stored properly.
Staff do not ensure that the facility is kept free from tripping hazards.
Inadequate food services.
Staff do not ensure that fire alarms are operable.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 7/13/2026, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator Sandra Riffey.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

**Report continued on 9099-C**
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 59-AS-20260413150920
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: GOLD COUNTRY ASSISTED LIVING
FACILITY NUMBER: 095920119
VISIT DATE: 07/13/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
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Staff do not respond to residents' requests for assistance.
Based on resident and staff interviews, there was insufficient evidence to support the allegation that staff did not respond to residents’ requests for assistance. Residents interviewed stated that staff respond when assistance is requested and that their needs are addressed. Staff interviewed stated they respond to residents’ requests as soon as possible; however, there may be occasional delays when they are assisting another resident. The Department did not obtain evidence that staff failed to respond to residents’ requests for assistance. Therefore, this allegation is determined to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.
Staff member verbally abuses residents in care.
Staff member emotionally abuses residents in care.
Based on resident and staff interviews, there was insufficient evidence to support the allegations that staff verbally abused or emotionally abused residents in care. Residents interviewed stated that staff are kind, respectful, and helpful and that they have not experienced or witnessed verbal or emotional abuse. Staff interviewed stated that all residents are treated with dignity, respect, and like family. The Department did not obtain evidence to support the allegations of verbal or emotional abuse. Therefore, these allegations are determined to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.
Staff are not adequately trained.
Based on documents obtained and statement reviewed, the department determined that Licensee does ensure staff have required training. Department reviewed trained records and noted that staff were adequately trained per regulations with topics including medication management, Dementia, resident rights, activities, ADLs, etc. Records show the required training hours. Staff interviewed stated that staff do receive training. Based on information gathered staff are receiving the required training. Department finds allegation to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Continue on page 2 ...
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 59-AS-20260413150920
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: GOLD COUNTRY ASSISTED LIVING
FACILITY NUMBER: 095920119
VISIT DATE: 07/13/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued page 2 ...

Staff do not provide residents with activities.
Based on the Department’s observations made during multiple visits to the facility and resident interviews, there was insufficient evidence to support the allegation that staff did not provide residents with activities. During each visit, the Department observed scheduled activities being offered and available to residents throughout the day. Residents interviewed stated they had a variety of activities to choose from daily and were satisfied with the activity program. The Department did not observe or obtain evidence to support the allegation. Therefore, this allegation is determined to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.
Staff did not ensure that toxic substances were stored properly.
Staff do not ensure that the facility is kept free from tripping hazards.
Staff do not ensure that fire alarms are operable.
Based on the Department’s observations conducted during multiple inspections of the facility, there was insufficient evidence to support the allegations that staff failed to ensure toxic substances were properly stored, failed to keep the facility free from tripping hazards, and failed to ensure the fire alarm system was operable. During each inspection, the Department observed that toxic substances were stored in secured locations inaccessible to residents, walkways throughout the facility were clear and free of tripping hazards, and the fire alarm system appeared to be operable. The Department did not observe any conditions or obtain any evidence to support the allegations. Therefore, these allegations are determined to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.
Inadequate food services.
Based on resident interviews, there was insufficient evidence to support the allegation that the facility provided inadequate food services. Residents interviewed stated that they receive enough food to eat and are provided with a variety of meals. Some residents expressed that they would prefer to prepare or cook their own food; however, they did not report concerns regarding the quantity or availability of meals provided by the facility. The Department did not obtain evidence to support the allegation that food services were inadequate. Therefore, this allegation is determined to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Exit interview conducted. Report left with facility.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5