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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 317005902
Report Date: 11/05/2025
Date Signed: 11/06/2025 10:06:18 AM

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
09/15/2025 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20250915111945
FACILITY NAME:CORNERSTONE CRISIS RESIDENTIALFACILITY NUMBER:
317005902
ADMINISTRATOR:JENNA ALLENFACILITY TYPE:
772
ADDRESS:101 CIRBY HILLS DRIVETELEPHONE:
(916) 788-8144
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:14CENSUS: 5DATE:
11/05/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Jenna AllenTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff did not provide responsible party with resident's records when requested.
INVESTIGATION FINDINGS:
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On 11/5/25 Licensing Program Analyst (LPA) Kevin Mknelly spoke to Jenna Allen, Administrator to deliver complaint findings for the above allegation.
LPA reviewed resident records, facility records and conducted extensive interviews.
LPA finds that the allegations cited above are substantiated.

Records and statements found that Cornerstone did not comply with the patient records request regulations. R1’s conservator is considered R1’s “Patient’s Representative”. Patient's Representative have the same rights to records requests as the patient. Records required under Title 22 include but are not limited to : Admissions packet; Medical assessment; Record of any illness or injury requiring treatment by a physician or dentist and for which the facility provided assistance to the client in meeting his/her necessary medical and dental needs; Record of current medications; Functional assessment;
Date of termination of services; and, An account of the client's cash resources, personal property,
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Kevin Mknelly
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
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 7
Control Number 59-AS-20250915111945
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: CORNERSTONE CRISIS RESIDENTIAL
FACILITY NUMBER: 317005902
VISIT DATE: 11/05/2025
NARRATIVE
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and valuables entrusted. Items requested by the conservator for records not required by Title 22 or of which the licensee, or other agencies, may have proprietary control must be sought through other means.

As a result of this investigation, LPA finds allegation to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care.

Report reviewed with Administrator . Copy of this report and appeal rights provided.
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Kevin Mknelly
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 59-AS-20250915111945
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: CORNERSTONE CRISIS RESIDENTIAL
FACILITY NUMBER: 317005902
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/06/2025
Section Cited
CCR
80070(e)
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Client Records (e) A client's records shall be open to inspection by the client's authorized representative(s), if any. This requirement was not met based on records and statements.
This posed a potential risk to the resident’s rights.
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During this visit LPA confirmed that the requested records have been provided to R1's representative. LPA confirmed that an additional request has been made and that request is in process and will be met within the required period.
This POC is cleared by visit.
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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.
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Kevin Mknelly
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 7
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
09/15/2025 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20250915111945

FACILITY NAME:CORNERSTONE CRISIS RESIDENTIALFACILITY NUMBER:
317005902
ADMINISTRATOR:JENNA ALLENFACILITY TYPE:
772
ADDRESS:101 CIRBY HILLS DRIVETELEPHONE:
(916) 788-8144
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:14CENSUS: 5DATE:
11/05/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Jenna AllenTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff did not allow resident to leave facility.
Staff forced religious practices on resident.
INVESTIGATION FINDINGS:
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On 11/5/25, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with xxx xxx.

LPA conducted records review and extensive interviews.
LPA is unable to find and or meet the preponderance, per policy.

On 7/25/25, Administrator and R1’s representative met to discuss the request for R1 to leave Cornerstone on 7/30/25 and return on 8/1/25 so that R1could attend his grandmother’s funeral on 7/31/25. Cornerstone is a short-term crisis treatment program. If a client is stable enough to leave the program for 3 days, this would indicate that crisis residential services are no longer medically necessary, and the person can discharge from the program. At the time, the program recommended R1 not leave due to instability. However, Cornerstone is not a locked facility, and residents are free to leave the program on their own free will, however, if not they are not guaranteed to have their bed saved if the outing was not pre-approved by Cornerstone.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Kevin Mknelly
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 59-AS-20250915111945
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: CORNERSTONE CRISIS RESIDENTIAL
FACILITY NUMBER: 317005902
VISIT DATE: 11/05/2025
NARRATIVE
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Interviews and records of therapy group participation notes found no record of a group in which R1 participated to have an overtly religious content. Staff interviewed stated that religious content by the program is prohibited and religious conversations by staff are prohibited due to some clients having a religious content to their delusional behaviors. Clients who were in attendance at Cornerstone at the time of R1’s stay are no longer present and contact information was not on record.

As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview with administrator.
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Kevin Mknelly
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 7