342701251-2-4-2026-27-AS-LKIG-DR8VPB-20260212153625

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 02/04/2026
Date Signed: 02/04/2026 02:10:36 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
12/04/2025 and conducted by Evaluator Avelina Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20251204100110

FACILITY NAME:	APPLE RIDGE ASSISTED LIVING, LLC		FACILITY NUMBER:	342701251
ADMINISTRATOR:	ILONA CORPUS		FACILITY TYPE:	740
ADDRESS:	3950 ANNADALE LANE		TELEPHONE:	(916) 489-6900
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95821
CAPACITY:	94	CENSUS: 80	DATE:	02/04/2026
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Steven Bush		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Staff did not prevent the spread of a lice.

INVESTIGATION FINDINGS:

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On February 04, 2026, at 12:25 PM, Licensing Program Analyst (LPA) Avelina Martinez arrived at the facility unannounced to deliver complaint findings. LPA Martinez met with Steven Bush and explained the purpose of today's visit.

Throughout the course of this investigation, LPA Martinez conducted interviews, reviewed facility records, and resident records. Confidential interviews were conducted with eight individuals during the period of December 08, 2025, to January 21, 2026. Based on record reviews, it was confirmed that there was one resident with lice. During two confidential interviews, LPA Martinez was informed that there was a second resident confirmed with lice; however, the interviewees were not able to provide the name of the resident. Based on four staff interviews, there was only one resident diagnosed with lice. Due to the above noted information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, and therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Avelina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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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