342701251-2-13-2026-27-AS-LKIG-DRWNSW-20260306094349

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 02/13/2026
Date Signed: 02/13/2026 12:06:18 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
12/12/2025 and conducted by Evaluator Avelina Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20251212160853

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: 74	DATE:	02/13/2026
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Steven		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff leave residents unsupervised for an extended period of time

INVESTIGATION FINDINGS:

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Licensing Program Analyst Avelina Martinez conducted an unannounced complaint inspection with the above facility on February 13, 2026 at 9:15 AM and met with Steven Bush. The purpose of the inspection was to deliver complaint findings for the above allegation.

Confidential interviews were conducted with eleven individuals during the period of December 22, 2025, to January 21, 2026.

Based on interviews conducted and records reviewed, it was determined that there was not sufficient evidence to indicate that residents were left unsupervised for an extended period of time on December 12, 2025. The Administrator reported there were sufficient staff members working on December 12, 2025. The Administrator also provided work schedule documentation to show that the facility was fully staffed on December 12, 2025.
Continued..

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Avelina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026

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 2

Control Number 27-AS-20251212160853

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: 02/13/2026

NARRATIVE

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five out of five facility staff members reported that the facility is not short staffed, and there were sufficient staff members working on December 12, 2025, to supervise residents. Three out four residents reported having no issues with staff supervision. One out four residents reported they were left unsupervised for an extended period of time. 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.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Avelina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2026

LIC9099 (FAS) - (06/04)

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