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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 340312462
Report Date: 03/17/2026
Date Signed: 03/17/2026 01:12:29 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
01/13/2026 and conducted by Evaluator Sabrina Calzada
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20260113111002
FACILITY NAME:ACE-IT IIFACILITY NUMBER:
340312462
ADMINISTRATOR:LACY DE LA FUENTEFACILITY TYPE:
775
ADDRESS:8089 MADISON AVE, SUITE 4TELEPHONE:
(916) 962-2766
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:60CENSUS: 46DATE:
03/17/2026
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Stephanie Howard, Program Director TIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Facility is not reporting to required agencies.
INVESTIGATION FINDINGS:
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LPA Sabrina Calzada arrived unannounced to complete the investigation and deliver findings to a complaint received January 13, 2026. LPA met with Administrator Designee, Don Hollingsworth and stated the reason for the inspection. LPA observed a group of clients and staff leaving upon arriving to the location and was advised the Program Director was attending the group outing. The Administrator returned at 12:14 pm. LPA was advised client (C1) has not attened Day Program for approximately (2) weeks due to medical reasons.

During the investigation, LPA interviewed the Adult Day Program Director, Assistant Day Program Director, a manager at a transportation company, client (C1), and the Administrator of the residential facility where client (C1) resides. LPA reviewed documentation, including (C1’s) Physician’s Report, and Shared Information Reports (SIR) for (2) falls. (C1) began attending this day program in May, 2023.

The results of the investigation are as follows:
*cont on 9099C-1..
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
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 6
Control Number 59-AS-20260113111002
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: ACE-IT II
FACILITY NUMBER: 340312462
VISIT DATE: 03/17/2026
NARRATIVE
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9099C-1.. Allegation: Facility is not reporting to required agencies. The allegation states that the Day Program is not properly reporting to all required agencies.

The Director indicated she completed a Shared Information Report (SIR) and gave it to the Regional Center and to the residential care home following the falls but did not provide a copy to the Department (CCLD), as she was not sure if these falls were a reportable event or just a "Shared Information Report " to be sent to the Regional Center, the client’s residence and their corporate office.

The Assistant Director explained that the staff who witnesses an incident will complete the SIR, and then he or the Program Director “will review it and send it to the Regional Center, Risk Management and our Home Office”.

The administrator of the residential care facility confirmed she has received multiple incident reports from the Day Program with the last one received in January 2026.

Per Regulation, 82061 Reporting Requirements, a report shall be made to the licensing agency within the agency's next working day during its normal business hours during its normal business hours. In addition, a written report containing the information specified in Section 82061(a)(2) shall be submitted to the licensing agency within seven days following the occurrence of the event.



Based on interviews conducted and documentation reviewed, the allegation is found to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met: Refer to the 9099-D.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
01/13/2026 and conducted by Evaluator Sabrina Calzada
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20260113111002

FACILITY NAME:ACE-IT IIFACILITY NUMBER:
340312462
ADMINISTRATOR:LACY DE LA FUENTEFACILITY TYPE:
775
ADDRESS:8089 MADISON AVE, SUITE 4TELEPHONE:
(916) 962-2766
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:60CENSUS: 46DATE:
03/17/2026
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Stephanie Howard, Program Director TIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Facility staff not providing care and supervision resulted in client falls.
INVESTIGATION FINDINGS:
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LPA Sabrina Calzada arrived unannounced to complete the investigation and deliver findings to a complaint received January 13, 2026. LPA met with Administrator Designee, Don Hollingsworth and stated the reason for the inspection. LPA observed a group of clients and staff leaving upon arriving to the location and was advised the Program Director was attending the group outing. The Administrator returned at 12:14 pm. LPA was advised client (C1) has not attened Day Program for approximately (2) weeks due to medical reasons. There were (46) clients attending Day Program today with (11) staff and the Program Director.

During the investigation, LPA interviewed the Adult Day Program Director, Assistant Day Program Director, a manager at a transportation company, client (C1), and the Administrator of the residential facility where client (C1) resides. LPA reviewed documentation, including (C1’s) Physician’s Report, and Shared Information Reports (SIR) for (2) falls. (C1) began attending this day program in May, 2023.

The results of the investigation are as follows:
*cont on 9099A-C-1..
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
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 6
Control Number 59-AS-20260113111002
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: ACE-IT II
FACILITY NUMBER: 340312462
VISIT DATE: 03/17/2026
NARRATIVE
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9099A-C-1.. Allegation: Facility staff not providing care and supervision resulted in client falls. The allegation states on two occasions, January 12, 2026 and December 9, 2025, client (C1) was observed to have abrasions to their forehead that day program staff described as "scratches" from a fall that (C1) sustained; however, the bruises appeared as large abrasions with swelling. Concerns were expressed that (C1) may not be receiving adequate care and supervision while attending day program.

The Physician’s Report (dated February 10, 2023) notes (C1) is able to ambulate without assistance, has some auditory impairment, is independent with toileting, and occasionally is not able follow instructions.

A manager at a transportation company stated that on two occasions, day program staff indicated (C1’s) abrasion was "just a scratch", but both times it didn't look like "just a scratch", and on December 9, 2025, the abrasion looked more like a “goose egg" and that (C1) may have had a concussion.

On January 14, 2026, the Program Director confirmed (C1) has been attending the day program since March 2023 and had a couple of falls last year outside of the day program. The Director explained that on December 9, 2025- (C1) fell in the restroom and sustained a bruise on their forehead, explaining that (C1) is "independent with toileting" and does not use a walker.

The Director stated that she was not at the day program on January 12, 2026, when (C1) fell and explained that (C1) was sitting in a chair without arms, fell asleep and then fell on the floor. The Director indicated that (C1) sustained a "red mark" that was "1 inch" but did not have any photos of the mark. The Director added that there will be additional chairs with armrests purchased soon and that she already had a "safety meeting" with all the supervisors about it. LPA observed several chairs in the room where (C1) fell and observed only some chairs to have arms. The Director explained that if a client falls, staff will check if First Aid is needed, "clients don't have the best balance" and she is "not sure" if (C1) would benefit from a walker.

The Assistant Program Director confirmed he was present on December 9, 2025, when (C1), fell in the bathroom and that (C1) sustained an injury like the recent one on January 12, 2026. The Assistant Director stated he assisted with paperwork (SIR) and advised the transportation company at the end of the day. The Assistant Director stated (C1) "stumbled with balance" and sometimes when (C1) is off the bus, they are "kind of wobbly, explaining that (C1) may be getting Dementia", according to what the residential home indicated. The Assistant Director stated (C1) is "stubborn", their "hearing is not the best", and staff usually keep extra eyes on (C1), adding that (C1) has a fall about every 2 months.



The Assistant Director indicated he was also present at the day program on January 12, 2026, when (C1) fell and that (C1) was not at the day program the following day, January 13, 2026. *cont on 9099C-2..
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 59-AS-20260113111002
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: ACE-IT II
FACILITY NUMBER: 340312462
VISIT DATE: 03/17/2026
NARRATIVE
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9099A-C-2.. The Assistant Director stated that (C1) has fallen before when sitting in chairs without armrests and after falling asleep, in 2023. The Assistant Director indicated the day program has a few chairs with armrests, and more will be purchased soon. The Assistant Director confirmed that (C1) would have fallen on the tile on January 12, 2026 and is not sure if the residential home took (C1) to the doctor.

On January 14, 2026 (11:30 am), LPA and the Program Director observed (C1) to have a healing abrasion on the left side. (C1) indicated they are doing "okay" when asked. LPA observed (C1) to be ambulating without an assistive device, their balance to be wobbly, and (C1) wearing elastic shoe laces that were lose.

A Lead staff at the Day Program stated on March 17, 2026 that (C1) has not attended Day Program for approximately (2) weeks as they had some medical issues.

On March 17, 2026, LPA spoke to the Administrator of (C1's) residential facility and was informed that (C1) is currently at a skilled nursing facility and receiving Physical Therapy for stability after being hospitalized. The administrator explained that (C1) was taken to the Emergency Room on February 27, 2026, due to their vitals, high blood sugar and not being able to walk, and was admitted for additional testing where it was discovered there was fluid on the left knee. The fluid was drained and (C1) was discharged. The administrator confirmed (C1) has not fallen at the residential home but fell when on an outing with their family in 2024, commenting that "C1's left knee is very weak".

LPA and the residential Administrator discussed the incident on January 12, 2026 when (C1) fell asleep in a chair without armrests. The Administrator explained that (C1) is “always sleepy” and when (C1) sits down, they will “fall asleep fast”, so they do not allow (C1) to sit down on chairs ,but ask that he sits on the couch.. LPA also discussed how she observed (C1) to be wearing elastic shoelaces that were lose on January 14, 2026 and one of the shoes came of when (C1) fell on December 9, 2025, in the bathroom. The administrator stated she would ensure the shoelaces provide enough support to keep the shoes from falling off when worn.
Based on information obtained, the allegation is found to be 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. Copy of report provided.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 59-AS-20260113111002
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: ACE-IT II
FACILITY NUMBER: 340312462
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/17/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2026
Section Cited
CCR
82061(a)(1)(D)
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82061 Reporting Requirements (a) Upon the occurrence, during the hours the day program is providing services to the client, of any of the events specified in Section 82061(a)(1), a report shall be made to the licensing agency within the agency's next working day during its normal business hours. In addition, a written report containing the information specified in Section 82061(a)(2) shall be submitted to the licensing agency within seven days following the occurrence of the event. (1) Events reported shall include, but not be limited to, the following: (D) Any unusual incident which threatens the physical or emotional health or safety of any client: This requirement is not met as evidenced by:
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Licensee/Administrator agree to review Regulation 82061 with staff and submit a signed statement of its understanding.

LPA was provided with a copy of the Shared Information Report (used by the Regional Center) on January 14, 2026, for each fall incident noted.
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Based on interviews conducted and documentation reviewed, the Licensee did not ensure that a written incident report was submitted to the Department within (7) days of when (C1) fell and sustained an abrasion on their head on December 9, 2025 and on January 12, 2026 which posed a potential health and safety risk to clints in care.
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Administrator stated she will review if any additional SIR's need to be submitted to CCLD.
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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: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6