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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315920040
Report Date: 09/25/2024
Date Signed: 09/25/2024 12:27:15 PM

Unfounded


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
07/08/2024 and conducted by Evaluator Todd Tryon
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20240708155450
FACILITY NAME:SIERRA RIDGE SENIOR LIVINGFACILITY NUMBER:
315920040
ADMINISTRATOR:JENNIFER FUSTONFACILITY TYPE:
740
ADDRESS:3625 BLUE OAKS DRTELEPHONE:
(530) 718-1553
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:65CENSUS: 49DATE:
09/25/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jennifer Fuston, Executive DirectorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Licensee does not ensure sufficient number of staff on site to assist residents with toileting needs.
Staff are not providing adequate laundry services for resident
INVESTIGATION FINDINGS:
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On 9/25/2024 LPA Tryon and LPA Gunby visited the facility to complete the complaint. LPAs met with Executive Director Jennifer Fuston.
During the course of the investigation, LPA has toured the facility, checked resident rooms and closets, inspected the laundry area, visited residents in common and dining areas, and interviewed 6 staff and ED.
Regarding the allegation that Licensee does not ensure sufficient number of staff on site to assist residents with toileting needs, LPA learned that there has been an issue with hiring and retaining qualified staff. However, during the past months staff who were present worked hard to meet resident needs. Even though residents may have had to wait a little longer, residents appear to have had basic needs met by staff who were present. At this time the facility has been working hard to maintain a staff consisting of 4 caregivers and 2 med techs on day and evening shifts; and 2 caregivers and 1 med tech on night (NOC) shift. The facility does use agency staff to cover shifts when needed. LPA finds the allegation to be unfounded.
Regarding the allegation that staff are not providing adequate laundry services for resident, LPA learned that
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
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
Control Number 59-AS-20240708155450
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: SIERRA RIDGE SENIOR LIVING
FACILITY NUMBER: 315920040
VISIT DATE: 09/25/2024
NARRATIVE
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the facility has had trouble in past months with keeping a dedicated laundry person in the facility. However, during times that a laundry person was not available, other staff have pitched in and made sure laundry got done. If it was noted that a resident was running low on clean clothes, someone from the staff or administration would do laundry to make sure there were clean clothes. The facility now has been successful in hiring 2 full-time housekeepers to clean and do laundry. So even though the situation was a little rough for staff for a while, they did get clothes washed for residents. Allegation is unfounded.

A finding of unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 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
07/08/2024 and conducted by Evaluator Todd Tryon
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20240708155450

FACILITY NAME:SIERRA RIDGE SENIOR LIVINGFACILITY NUMBER:
315920040
ADMINISTRATOR:JENNIFER FUSTONFACILITY TYPE:
740
ADDRESS:3625 BLUE OAKS DRTELEPHONE:
(530) 718-1553
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:65CENSUS: 49DATE:
09/25/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jennifer Fuston, Executive DirectorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
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9
Staff left resident in urine soaked clothing for an extended period of
time
INVESTIGATION FINDINGS:
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2
3
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5
6
7
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9
10
11
12
13
 On 8/25/2024 LPA Tryon and LPA Gunby visited the facility to complete the complaint. LPAs met with Executive Director Jennifer Fuston.
During the course of the investigation LPA has toured the facility, resident rooms, laundry, kitchen, dining and common areas, visited with residents, spoken with ED and with 6 staff. LPA learned that there was an incident when a resident had a choking incident in the dining area, which might have been what witness saw; or there may have been another incident of a resident having an accident in the dining room as mentioned. Since a particular person was not named it is not possible to learn exactly what was witnessed, LPA learned that there are residents who may have frequent incontinence, and staff do get to them as soon as they can to assist. Therefore, at this time LPA finds the allegation to be Unsubstantiated. A finding of unsubstantiated means that although the allegation may have happend or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Exit interview conducted; Appeal rights provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
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 3