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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 01/16/2026
Date Signed: 01/16/2026 10:57:07 AM

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
01/13/2026 and conducted by Evaluator Avelina Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260113125202
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: 83DATE:
01/16/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Illona CorpusTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Facility staff did not keep resident's health care records confidential.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Avelina Martinez conducted an unannounced complaint inspection with the above facility on January 16, 2025, at 10:00 AM and met with Ilona Corpus. The purpose of the inspection was to deliver complaint findings for the above allegations.

During this investigation, LPA Martinez conducted interviews, reviewed records, obtained media post pictures, and reviewed facility social media posts. Based on LPA Martinez's observations and investigation, it was learned that the facility did not safegaurd R1's and R2's health care records and did not keep their health care records confidential. LPA Martinez reviewed facility social media posts on Facebook. On Tuesday January 13, 2026, at 2:45 PM, LPA Martinez observed that on December 26, 2025, the facility posted a picture of a facility staff member posing in front of residents' care records. The post revealed R1’s name and last name initial and bowel movement dates and times. Additionally, the post revealed resident 2’s name and last name and turning times and dates.
Continued...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Avelina Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026
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-20260113125202
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/13/2026
Section Cited
CCR
87506(c)(1)
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Resident Records 87506(c)(1): All information and records obtained from or regarding residents shall be confidential. The licensee shall be responsible for storing active and inactive records and for safeguarding the confidentiality of their contents.
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Facility removed the social media post on 01/16/26. Provide social media in-service training to facility staff. Staff agrees to email training documents by POC date 01/13/26 by 5:00 PM.
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This requirement was not met as evidence by: Based on observation, the licensee did not ensure R1's and R2's health care record was safeguarded and kept confidential. This posed a potential health and safety risk to R1 and R2.
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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: Avelina Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20260113125202
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: 01/16/2026
NARRATIVE
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LPA Martinez conducted a second review of the facility’s social media posts on Facebook on January 15, 2026. As of this date, the December 26, 2025, post remains posted on the facility’s Facebook Page. The social media post was removed on January 16, 2026.

As a result of this investigation, the Department finds this allegation to be Substantiated. A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiency cited on the LIC 9099-D page, per Title 22 Regulations. An exit interview was conducted, and a copy of this LIC 9099 report, LIC 9099-D page, and LIC appeal rights document were provided to the facility.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Avelina Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3