126803830-7-30-2026-21-AS-KMOA-DX4UNL-20260819154406

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 126803830
Report Date: 07/30/2026
Date Signed: 07/30/2026 12:24:27 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/15/2026 and conducted by Evaluator Christopher Arnhold

COMPLAINT CONTROL NUMBER: 21-AS-20260515122038

FACILITY NAME:	SEQUOIA SPRINGS SENIOR LIVING COMMUNITY		FACILITY NUMBER:	126803830
ADMINISTRATOR:	ALMA PERALTA		FACILITY TYPE:	740
ADDRESS:	2401 REDWOOD WAY		TELEPHONE:	(707) 726-0111
CITY:	FORTUNA	STATE: CA	ZIP CODE:	95540
CAPACITY:	92	CENSUS: 53	DATE:	07/30/2026
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Alma Peralta		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

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Staff did not ensure that the facility is free of hazards.
Staff did not prevent the facility from being in disrepair.

INVESTIGATION FINDINGS:

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At approximately 9:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct an investigation into the above allegations. LPA met with Fortuna Fire Inspector Jacob Basler and toured the building to review corrections that were noted on the Fire Inspection conducted on May 15, 2026. The items listed on the report were reviewed and appear to have been corrected. After the walk through LPA met with Executive Director Alma Peralta. During the course of this investigation, LPA tested all delayed egress doors and looked for areas containing hazards or in disrepair. The egress doors are operating as designed and open after 15 seconds of continuous pressure. An alarm is activated when the door is pressed and continues to sounds until reset by staff. LPA observed all exits were free from obstructions. LPA found items that were in need of repair but was informed they have been identified and repairs were already in progress.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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