<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209035
Report Date: 11/10/2025
Date Signed: 11/10/2025 02:44:28 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/04/2025 and conducted by Evaluator Jacques Leffall
COMPLAINT CONTROL NUMBER: 24-AS-20250904143424
FACILITY NAME:SADDLE RIDGE SENIOR LIVINGFACILITY NUMBER:
107209035
ADMINISTRATOR:REYES, ALANAFACILITY TYPE:
740
ADDRESS:675 W ALLUVIAL AVENUETELEPHONE:
(559) 325-8400
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY:148CENSUS: 124DATE:
11/10/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee Representative: Jason ReyesTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff mismanaged residents medications

INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/10/25 at 1:00pm Licensing Program Analyst's (LPA) J. Leffall and Licensing Promram Manager (LPM) S. Moua met with fcaility representatives in an office meeting. Findings were delivered on the aboove allegations.

The Department conducted interviews with staff, reviewed facility records, and reviewed resident files. LPA observed Losartan 50MG Take 1 tab by mouth everyday. Start date 9/17/25 and 1 tablet over of punch out date. 10 were punched out and there should have been 9 punched out. Pantoprazole 40mg Take 1 tablet by mouth ever day. Start date 9/12/25 and 1 tablet over of punch out date. 15 were punched out and there should have been 14 punched out. Clopidogrel 75mg take 1 tab by mouth everyday. Per Centrally Stored Medication Record, no start date is labled. Per tablet count start date written on medication bubble pack is 9/19/25. Per date of 9/19/25 there should have been 7 punched out but there were 8 tablets punched out. Asprin 81 mg tab chew. Chew and swallow 1 tablet by mouth every day. Per Centrally Stored Medication Record, no start date is labled. Per tablet count start date written on medication bubble pack is 9/19/25. Per date of 9/19/25 there should have been 7 punched out but there were 8 tablets punched out.


Based on observation, record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Citations were issued on complaint #24-AS-20251020113818.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Jacques Leffall
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/04/2025 and conducted by Evaluator Jacques Leffall
COMPLAINT CONTROL NUMBER: 24-AS-20250904143424

FACILITY NAME:SADDLE RIDGE SENIOR LIVINGFACILITY NUMBER:
107209035
ADMINISTRATOR:REYES, ALANAFACILITY TYPE:
740
ADDRESS:675 W ALLUVIAL AVENUETELEPHONE:
(559) 325-8400
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY:148CENSUS: DATE:
11/10/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee Representative: Jason ReyesTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not properly trainined

Staff did not provide proper food service to residents in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/10/25 at 1:00pm Licensing Program Analyst's (LPA) J. Leffall and Licensing Promram Manager (LPM) S. Moua met with fcaility representatives in an office meeting. Findings were delivered on the aboove allegations.

The Department conducted interviews with staff, and residents.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is Unsubstantiated. No deficiencies were issued.

Exit interview conducted. A copy of this report was distributed to Licensee Representative which confirms signature of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Jacques Leffall
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2