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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701107
Report Date: 06/30/2026
Date Signed: 06/30/2026 02:21:42 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
04/21/2026 and conducted by Evaluator Shakaricka Hughes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260421084925
FACILITY NAME:REGENCY PLACEFACILITY NUMBER:
342701107
ADMINISTRATOR:HEIDI CHARETTEFACILITY TYPE:
740
ADDRESS:8190 ARROYO VISTA DRIVETELEPHONE:
(916) 681-7800
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:61CENSUS: 78DATE:
06/30/2026
UNANNOUNCEDTIME BEGAN:
12:03 PM
MET WITH:Administrator: Martin NicholsTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff hit resident.



INVESTIGATION FINDINGS:
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On 06/30/2026, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with the facility administrator Martin Nichols and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the allegation above. The current census is 78.

Allegation: Staff hit resident.
It was alleged that staff hit a resident. This investigation consisted of interviews with facility staff and resident (R1). On 04/22/2026 LPA Hughes conducted a visit to the facility and interviewed two (2) facility staff who stated they witnessed facility staff (S3) physically strike a resident (R1) in the face on 4/18/2026 while assisting the resident with medication administration. Additional interview with the facility coordinator revealed the incident was immediately report to management on 4/20/2026, and facility staff (S3) were removed from the facility pending an internal investigation. Interview with resident (R1) stated that facility staff is nice to them, however (R1) was unable to recall the incident involving (S3).
Continuation 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
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 3
Control Number 27-AS-20260421084925
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: REGENCY PLACE
FACILITY NUMBER: 342701107
VISIT DATE: 06/30/2026
NARRATIVE
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On 04/30/2026 LPA Hughes interviewed facility staff (S3) who stated they assisted with medication administration and denied physically assaulting (R1). Facility staff (S3) stated that they touched R1’s face only after (R1) spit out their medications. This was observed not in compliance with Title 22 regulation 87468.1(a)(3) as the facility did not ensure that resident (R1) was treated with dignity and respect and was free from physical abuse while in care.


As a result, this allegation is SUBSTANTIATED. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. An exit interview was conducted with Martin and a copy of the LIC 9099, LIC 9099-D pages and appeal rights were provided to facility.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20260421084925
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: REGENCY PLACE
FACILITY NUMBER: 342701107
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/01/2026
Section Cited
CCR
87468.1(a)(3)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly...(3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or interfering with daily living functions...
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The facility agrees to dissassociate facility staff (S3) from the facility effective immediately. The facility also agrees to conduct training on Resident Personal Rights in RCFE's and send a copy of the staff sign-in sheet and training vendor used.
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This requirement was not met as evidenced by:
The facility did not ensure a resident in care (R1) was kept free from physical abuse as resident (R1) was hit in the face by staff (S3) while they were assisting with medication administration.
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The facility will send a copy of the staff disassociation via email by 07/01/2026.
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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: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3