342701251-12-2-2025-27-AS-CACL-DP9TEJ-20251211133955

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 12/02/2025
Date Signed: 12/02/2025 02:31:44 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
07/01/2025 and conducted by Evaluator Pang Lee

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20250701115339

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: 80	DATE:	12/02/2025
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Ilona Corpus		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff leave resident in soiled clothing for an extended period of time

INVESTIGATION FINDINGS:

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On 12/02/2025, 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 finding for the above allegation. The current census is 80. A brief interview was conducted with Executive Director, Corpus.

It was alleged that staff did not respond to resident’s call button in a timely manner. The investigation included staff and resident interviews, a review of facility records, and direct observations. During interviews, 3 out of 5 staff members reported that adding one extra staff member per hall would help prevent delays in meeting residents’ needs. Additionally, 5 out of 7 residents stated that there are not enough staff available, particularly when responding to pendant call requests and getting their incontinence brief change.

CONTINUED LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025

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-20250701115339

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: 12/02/2025

NARRATIVE

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Residents reported waiting from 30 minutes to several hours to be changed out of their soiled incontinence briefs. Moreover, according to R1’s LIC 602 Physician’s Report dated 09/02/2025, R1 requires assistance with toileting. A review of the facility’s “Past Events” call log showed response times ranging from approximately 30 minutes to three hours. Residents expressed that staff often take a long time to respond or, at times, do not respond at all when the pendant is pressed. Some residents reported leaving their rooms to find staff because their calls went unanswered. During an unannounced visit on 10/03/2025, LPA interviewed two residents, (R1 and R2) who expressed concerns about delayed incontinence care. On the same day, the LPA observed two residents press their call pendants and wait approximately 30 minutes without a staff response. While waiting, the LPA observed two care staff and two med-techs walking past the residents’ rooms, unaware of the pending calls. LPA then notified the Executive Director, Ilona, regarding the residents who had been waiting. LPA confirmed that the call alerts appeared on the monitor at the front desk; however, there was no audible alert unless staff visually noticed the calls on the screen. Based on the statement conducted, records reviewed and observation during the investigation process LPA was able to corroborate the allegation; therefore, the allegation is found to be substantiated.

The deficiency related to staff not responding to residents’ call buttons in a timely manner was not cited, as the citation was previously cited on 11/25/2025 under complaint control #27-AS-20250507151513. 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: 12/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025

LIC9099 (FAS) - (06/04)

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