315920040-5-1-2025-59-AS-TORZ-DGEUT8-20250506155132

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 315920040
Report Date: 05/01/2025
Date Signed: 05/01/2025 04:12:00 PM

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
08/05/2024 and conducted by Evaluator Todd Tryon

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20240805134831

FACILITY NAME:	SIERRA RIDGE SENIOR LIVING		FACILITY NUMBER:	315920040
ADMINISTRATOR:	JENNIFER FUSTON		FACILITY TYPE:	740
ADDRESS:	3625 BLUE OAKS DR		TELEPHONE:	(530) 718-1553
CITY:	AUBURN	STATE: CA	ZIP CODE:	95602
CAPACITY:	65	CENSUS: 45	DATE:	05/01/2025
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Alexis Thacker, Executive Director		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff not providing care and supervision to resident

INVESTIGATION FINDINGS:

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On 5/1/2025 LPA Tryon visited the facility to complete the complaint. LPA met with Executive Director Alexis Thacker.
Over the course of the investigation LPA has interviewed 6 staff, reviewed documentation. LPA found that resident R1 had fallen several times while living at the facility. Through interview and review, LPA learned that R1 spent a lot of time walking around the facility; and walked head-down. R1 had a frequently recurring medical condition. When the condition popped up, R1 would suddenly start running down the hall, head-down. Staff would get medical attention ASAP for R1, but since the condition recurred fairly often, it would happen before anyone was aware, and R1 would run. When R1 ran, R1 would run into objects like tables/chairs, the wall; and then fall. Staff tried diligently to redirect R1 to activities; tried putting R1 to bed after meals to rest; tried having R1 sit, but R1 would frequently "bounce back up" and attempt to run. Hospice services were started, and saw R1 frequently, and treated the medical issues as quickly as possible, but agreed that there would likely be falls due to the behaviors related to the condition and the apparent need to run. It is not possible to say at this time if additional staff/supervision would have made any difference

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

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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Control Number 59-AS-20240805134831

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: 05/01/2025

NARRATIVE

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to the number of falls, as staff could be right there, and R1 would still get up and run; and staff could not stop R1 or obviously could not do any type of restraint.
Therefore, at this time, LPA finds the allegation to be UNSUBSTANTIATED. A finding of unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the the alleged violation occurred.

Appeal rights provided; exit interview conducted.

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025

LIC9099 (FAS) - (06/04)

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