342701251-10-31-2025-27-AS-CACL-DNDU6Q-20251113141843

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 10/31/2025
Date Signed: 10/31/2025 02:33:55 PM

Unsubstantiated

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
07/24/2025 and conducted by Evaluator Pang Lee

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20250724091520

FACILITY NAME:	APPLE RIDGE ASSISTED LIVING, LLC		FACILITY NUMBER:	342701251
ADMINISTRATOR:	WHITE, CHARLES		FACILITY TYPE:	740
ADDRESS:	3950 ANNADALE LANE		TELEPHONE:	(916) 489-6900
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95821
CAPACITY:	94	CENSUS: 83	DATE:	10/31/2025
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Ilona Corpus		TIME COMPLETED:	02:50 PM

ALLEGATION(S):

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Staff did not get timely medical care for resident
Staff are not following physician’s orders

INVESTIGATION FINDINGS:

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On 10/31/2025, Licensing Program Analyst (LPA) Pang Lee arrived unannounced to this facility to conduct a complaint visit. LPA met with Executive Director Ilona Corpus and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the above allegations. A brief interview conducted with Executive Director Corpus. The current census is 83.

It was alleged that staff did not obtain timely medical care for a resident and that staff are not following physician’s orders. The investigation included a review of records, residents’ medications, observations, and interviews with staff, residents, resident's responsible party (RP) and an outside agency. Based on record review and interviews, Resident 1 (R1) was sent to the hospital on 01/30/2025 for dermatitis and was prescribed medications for skin itching and redness. On 07/19/2025, R1 was again sent to the hospital for two separate rashes, and new medications were prescribed.

CONTINUED LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2025

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

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20250724091520

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: APPLE RIDGE ASSISTED LIVING, LLC	FACILITY NUMBER: 342701251
	VISIT DATE: 10/31/2025

NARRATIVE

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Review of R1’s Medication Administration Record (MAR) from February 2025 through October 2025 revealed no gaps or missed doses related to rash or scabies medications. During two separate unannounced visits on 07/29/2025 and 10/27/2025, LPA Lee reviewed medications for R1, and did not observe any deficiencies. Interviews were conducted with seven residents, all of whom stated they had no concerns regarding staff obtaining timely medical care, and their medications being administered. R1 also confirmed that they receive their prescribed medications and apply their rash medication independently and have no concerns about their medications. Interviews with five facility staff also stated that medications are administered to residents as well as residents’ rash medications. Interview with R1's responsible party
(RP) also stated no concerns with the allegations. An interview with an outside agency confirmed that skin scraping is the proper way to diagnose scabies and noted that R1 did not undergo this procedure. The outside agency also explained that emergency departments often prescribe similar medications for both rash and scabies as a precaution. Based on the records review and statements conducted during the investigation process LPA Lee was unable to corroborate the allegation that staff did not obtain timely medical care for a resident and that staff are not following physician’s orders.

The investigation revealed the preponderance of evidence standards has not been met; therefore, the above allegations is found to be UNSUBSTANTIATED. A finding that the complaint allegations are unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

An exit interview was conducted with Executive Director Corpus, and a copy of this report was provided to the facility.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2025

LIC9099 (FAS) - (06/04)

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