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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315920040
Report Date: 08/19/2025
Date Signed: 08/19/2025 03:51:18 PM

Substantiated


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
05/20/2025 and conducted by Evaluator Todd Tryon
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20250520151357
FACILITY NAME:SIERRA RIDGE SENIOR LIVINGFACILITY NUMBER:
315920040
ADMINISTRATOR:ALEXIS THACKERFACILITY TYPE:
740
ADDRESS:3265 BLUE OAKS DRIVETELEPHONE:
(530) 718-1553
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:65CENSUS: 46DATE:
08/19/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Tony Sellers, Interim EDTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff are not permitting resident to leave the facility
Staff are not permitting resident to have visitors
INVESTIGATION FINDINGS:
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On August 19, 2025 LPA Tryon visited the facility to complete the complaint. LPA met with Interim Executive Director Tony Sellers and spoke by phone with covering ED Alyssa Sellers.
LPA has interviewed witnesses, resident, Directors and staff.
In speaking with witnesses, LPA learned that on at least one occassion, family members came to visit resident R1 at the facility. They were told by the ED at the time that R1 could not go into the community with them; and that they needed to leave. Therefore, the allegations that staff are not permitting resident to leave the facility; and staff are not permitting resident to have visitors is Substantiated. A finding of substantiated means that the allegation is valid because a preponderance of the evidence standard has been met.
Deficiency cited as per Title 22 Regulations and the Health and Safety Code.

Appeal rights provided, exit interview conducted.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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 3
Control Number 59-AS-20250520151357
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/19/2025
Section Cited
CCR
87468.1(a)(6)
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(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: To leave or depart the facility at any time and to not be locked into any room, building, or on facility premises by day or night.
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The facility will do a review of resident rights with all staff and submit proof of training to CCL by 9/19/2025.
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Through interview LPA has learned that on at least one occassion R1 was denied the right to go into the community with a family member, causing a potential violation of Personal Rights.
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Type B
09/19/2025
Section Cited
CCR
87468(a)(11)
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Residents in all residential care facilities for the elderly shall have all of the following personal rights: To have their visitors... permitted to visit privately during reasonable hours and without prior notice, provided that the rights of other residents are not infringed upon.
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As above, The facility will do a review of resident rights with all staff and submit proof of training to CCL by 9/19/2025.
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Through interview of witnesses LPA has learned that on at least one occassion family members of R1 were denied entrance to the facility to visit R1. This is a potential violation of Personal Rights.
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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: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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
05/20/2025 and conducted by Evaluator Todd Tryon
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20250520151357

FACILITY NAME:SIERRA RIDGE SENIOR LIVINGFACILITY NUMBER:
315920040
ADMINISTRATOR:ALEXIS THACKERFACILITY TYPE:
740
ADDRESS:3265 BLUE OAKS DRIVETELEPHONE:
(530) 718-1553
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:65CENSUS: 46DATE:
08/19/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Tony Sellers, Interim EDTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not permitting resident to receive phone calls
Staff are mismanaging resident's medication
INVESTIGATION FINDINGS:
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Regarding the allegation that staff are not permitting resident to receive phone calls, LPA has interviewed witnesses, staff and resident. Several witnesses stated that when a phone call was attempted to resident R1 they were told that he was in an activity and not available to come to the phone. It was stated that multiple attempts were made to contact R1. R1 has said no phone calls were denied. LPA is not able to say with certainty whether R1 was actually in an activity or not able to come to the phone or not. Allegation is unsubstantiated. Regarding the allegation that staff are mismanaging medication, no specific medication or times, dates, etc. were given in the complaint. LPA has reviewed the printed MARS (Medication Administration Records) for R1. It appears that R1 has refused to take several different medications on multiple occassions over the past few months BY CHOICE; refusal was documented; and facility nurse has stated that the doctor held a medication at one point for a brief time. However, LPA cannot find any evidence that medications were missed due to any kind of staff error. Since it is not known what medication may have been missed, LPA is not able to substantiate. Allegation is Unsubstantiated. A finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidene to prove that the alleged violation occurred.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2025
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