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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209035
Report Date: 11/13/2025
Date Signed: 11/13/2025 12:23:35 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
11/04/2025 and conducted by Evaluator Jacques Leffall
COMPLAINT CONTROL NUMBER: 24-AS-20251104092210
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: 114DATE:
11/13/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator: Michelle RamosTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff are mismanaging residents medications

Staff are falsifying medication log
INVESTIGATION FINDINGS:
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On 11/13/25 at 9:30 am Licensing Program Analyst's (LPA) J. Leffall conducted an initial complaint visit to open and to deliver findings on above allegations. LPA met with Administrator (A1) Michelle Ramos.

The Department reviewed facility records, and reviewed resident MAR's. LPA observed from the Memory Care Med Tech Room R1's medication: Denepezil 10mg tablet/Take 1 tablet by mouth every morning. Start date 11/3/25. Count from 11/3/25 to 11/13/25 should be 11. 12 tablets were punched out total. Per medication count, 1 tablet over was punched out.

LPA observed from the Assisted Living Med Tech Room R2's medication: Montelukast 10 mg tablet/Take 1 tablet by mouth at bedtime. Start date 10/23/25. Count from 10/23/25 to 11/12/25 should be 21. 20 tablets were punched out total. Per medication count, 1 tablet short was punched out. Ferrous Sulfate 325mg (65mg) tablet/Take 1 tablet by mouth everyday in the morning. Start date 11/8/25. Count from 11/8/25 to 11/13/25 should be 6. 5 tablets were punched out total. Per medication count, 1 tablet short was 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.

The following deficincies are being cited and civil penalty issued Per Title 22 Regulations.

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

DATE: 11/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
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 24-AS-20251104092210
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: SADDLE RIDGE SENIOR LIVING
FACILITY NUMBER: 107209035
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/14/2025
Section Cited
CCR
87465(a)(4)
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a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:
(4) The licensee shall assist residents with self-administered medications as needed.

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Licensee agrees that all Med-Tech staff complete medication training. Licensee agees to submit completion documents to CCLD by POC due date.
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Based on records reviewed and interviews conducted, R1’s medication count is not accurate and medication administered does not match the medication label and the MARS, which poses an immediate Health & Safety risk to the residents.
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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.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Jacques Leffall
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2