312700574-9-2-2026-59-AS-LMUZ-DXTPK5-20260911112230

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 312700574
Report Date: 09/02/2026
Date Signed: 09/02/2026 11:49:29 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
05/15/2026 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20260515094823

FACILITY NAME:	ANSEL PARK SENIOR LIVING COMMUNITY		FACILITY NUMBER:	312700574
ADMINISTRATOR:	PAYNE, KEITH		FACILITY TYPE:	740
ADDRESS:	1200 ORCHID DRIVE		TELEPHONE:	(916) 250-0770
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	100	CENSUS: 82	DATE:	09/02/2026
		UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Executive Director - Aileen Enriquez		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Licensee does not ensure facility has sufficient staffing to meet the care needs of residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Talwinder Bains arrived unannounced to deliver complaint findings.
LPA met with Executive Director - Aileen Enriquez during today's inspection.

Based on interviews with staff and residents, the Department determined that there are enough staff to meet the needs of the residents in care and that residents are able to use the call buttons and receive help in a timely manner. Residents indicated they had no concerns with reaching staff when they require assistance however it can be delay in response time as staff were assisting other residents with their care needs, therefore, the allegations were Unsubstantiated.Based on documentation and interviews conducted, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED. No deficiencies are being cited.

Exit interview conducted. A copy of the report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026

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 3

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
05/15/2026 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20260515094823

FACILITY NAME:	ANSEL PARK SENIOR LIVING COMMUNITY		FACILITY NUMBER:	312700574
ADMINISTRATOR:	PAYNE, KEITH		FACILITY TYPE:	740
ADDRESS:	1200 ORCHID DRIVE		TELEPHONE:	(916) 250-0770
CITY:	ROCKLIN	STATE:CA	ZIP CODE:	95765
CAPACITY:	100	CENSUS: 82	DATE:	09/02/2026
		UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Executive Director - Aileen Enriquez		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Licensee allows unqualified staff to administer injections to residents.
Staff due not ensure soiled linens are removed from residents room.
Staff do not ensure residents room is kept free of mal odors.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Talwinder Bains arrived unannounced to deliver complaint findings.
LPA met with Executive Director - Aileen Enriquez during today's inspection.

The Department conducted interviews and reviewed facility records and conducted interviews with residents and staff.

**Continued on next page........

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026

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 3

Control Number 59-AS-20260515094823

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: ANSEL PARK SENIOR LIVING COMMUNITY	FACILITY NUMBER: 312700574
	VISIT DATE: 09/02/2026

NARRATIVE

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**Report continued .....

Allegation- Licensee allows unqualified staff to administer injections to residents. Unfounded

The department conducted record review, interviewed staff and residents to investigate this allegation. It was learnt that there are currently 2 residents at the facility who require insulin injections on daily basis and those residents can perform that task independently and/or minimal staff assistance, therefore this allegation was UNFOUNDED.

Allegation- Staff due not ensure soiled linens are removed from residents room. UNFOUNDED

Interviews conducted with the staff, and residents concluded that all the residents’ linens are cleaned weekly, unless one of the residents needs it done earlier and staff will do it. Staff interviews reflected that soiled linens were removed from residents’ rooms and were sent to laundry to wash. Residents interviewed reported that they have not had any issues not getting their linen cleaned. Based on this information, this allegation was UNFOUNDED.

Allegation- Staff do not ensure residents room is kept free of mal odors. UNFOUNDED

Department investigated allegation, “Staff do not ensure residents room is kept free of mal odors”. The facility was toured and facility was observed to be clean, sanitary, and free from odor. Resident rooms, common areas, kitchen area, and dining room were toured. Four (4) staff members were interviewed in which they stated housekeeping and other staff keep the facility clean and free from odor. Staff stated due to resident incontinent care needs, at times there may be a temporary smell, but staff take care of the problem in a timely manner. Due to interviews and observation, the department finds allegation to be UNFOUNDED

Based on the information obtained, these allegations are UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview was conducted and a copy of this report was provided.
Signature on these forms acknowledges receipt of these documents.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026

LIC9099 (FAS) - (06/04)

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