342701107-8-24-2026-27-AS-SLOZ-DX9UW2-20260824155600

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 342701107
Report Date: 08/21/2026
Date Signed: 08/24/2026 03:57:11 PM

Document Has Been Signed on 08/24/2026 03:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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
ADMINISTRATOR/ DIRECTOR:	MARTIN NICHOLS		FACILITY TYPE:	740
ADDRESS:	8190 ARROYO VISTA DRIVE		TELEPHONE:	(916) 681-7800
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95823
CAPACITY: 61		CENSUS:	DATE:	08/21/2026
TYPE OF VISIT:	Case Management - Legal/Non-compliance	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:30 AM
MET WITH:	REGENCY PLACE ACQUISITIONS OPCO LLC & NORTHSTAR		TIME VISIT/ INSPECTION COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	A Non-Compliance Conference (NCC) was conducted on this day, 08/21/2026 by the Sacramento South Regional Office via Microsoft Teams. The purpose of this NCC meeting was to discuss the high volume of deficiencies and the inability of this facility to remain in substantial compliance with regulations. Present at the meeting were Regional Manager (RM), Stephenie Doub, Licensing Program Managers (LPMs), Arielle Pascua and Stephen Richardson, Licensing Program Analyst (LPA), Sulma Lopez, Facility Administrator Martin Nichols, and Licensee representatives Steven Kregel and Julie Myers. The Non-Compliance Conference process was explained during this meeting to include the administrative process. During the review period from January 2025 to July 31, 2026, the facility has received (6) Type A violations citations regarding Neglect/ Lack of Supervision, (1) Type A violation citation for Physical Abuse/ Corporal Punishment, (1) Type B citation regarding Reporting Requirements, and (1) Type A citation for Medication Administration. Licensee agreed to do the following in order to bring the facility into compliance no later than the following date 08/272026: - Provide documentation of last in-service training on Post- Fall Assessments. - Provide documentation of last in-service training on Fall Procedures. - Provide documentation of last in-service training on when to call 911. - Provide documentation of last in-service training on Personal Rights. - Provide documentation of last in-service training for Medicine Technicians. Continued on LIC 809-C...

Arielle Pascua
Sulma Lopez
	DATE: 08/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 08/21/2026

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-Copy of LIC500 and LIC308
-Continue in-service training for Post-fall assessments, fall procedures, 911, personal rights, medication technicians at least every 6 months.

Community Care Licensing Department (CCLD) will do the following:
- Increase monitoring to quarterly visits.
- Licensee was offered TSP.

Completing the Non-Compliance Conference does not deprive the Department of its authority to take appropriate formal legal action under the Health and Safety Code, and due to the severity of the incident which resulted in the abuse of a client in care, this case has been referred to legal for review and possible administrative action.

Per California Code of Regulations (CCRs) - Title 22 no deficiencies are being cited during this visit. An exit interview was conducted, and a copy of this report was provided via email and an electronic email read receipt confirms receiving these documents. In addition, a copy of this report will be sent out certified mail.

NAME OF LICENSING PROGRAM MANAGER: Arielle Pascua
NAME OF LICENSING PROGRAM ANALYST: Sulma Lopez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/24/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2026

LIC809 (FAS) - (06/04)

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