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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 11/25/2025
Date Signed: 11/25/2025 01:34:05 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
09/16/2025 and conducted by Evaluator Pang Lee
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250916183948
FACILITY NAME:APPLE RIDGE ASSISTED LIVING, LLCFACILITY NUMBER:
342701251
ADMINISTRATOR:ILONA CORPUSFACILITY TYPE:
740
ADDRESS:3950 ANNADALE LANETELEPHONE:
(916) 489-6900
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:94CENSUS: 81DATE:
11/25/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Ilona CorpusTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff are mismanaging resident's medication resulting in hospitalization.
INVESTIGATION FINDINGS:
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On 11/25/2025 Licensing Program Analyst (LPA) Pang Lee and Avelina Martinez 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 allegation above. The current census is 81. A brief interview was conducted with Executive Director Corpus

It was alleged that staff were mismanaging residents’ medications, resulting in hospitalization. The investigation included interviews with staff and residents, as well as a review of facility records. During the interviews, 6 of 7 residents reported no concerns regarding medication management and stated that they are receiving their medications from staff. Additionally, 5 out of 5 staff members interviewed denied the allegation and stated that residents receive their medications according to physician orders, with documentation maintained in the Medication Administration Record (MAR) or residents’ files.

CONTINUED LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
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 2
Control Number 27-AS-20250916183948
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: 11/25/2025
NARRATIVE
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Staff also denied that any residents had been hospitalized due to medication mismanagement. A review of Resident 1’s (R1) MAR from July through November showed no discrepancies. R1’s seizure medications were administered as prescribed, with occasional refusals by R1 documented. According to R1’s LIC 624 Incident Report dated 09/17/2025, on 09/11/2025, paramedics were called after R1 was found on the floor in their room and reported feeling like vomiting; therefore, R1 was transported to the hospital. Hospital records indicate that R1 was admitted on 09/11/2025 due to a seizure and discharged on 09/12/2025. During two unannounced facility visits on 09/25/2025 and 11/17/2025, LPA Lee reviewed the medications of R1 and Resident 2 (R2) and found no discrepancies. Based on interviews and the record review conducted during the investigation, LPA Lee found no corroborating evidence that staff mismanaged residents’ medications resulting in hospitalization. Therefore, the allegation of medication mismanagement by staff is unsubstantiated.

The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation(s)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: 11/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
LIC9099 (FAS) - (06/04)
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