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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345002805
Report Date: 07/08/2026
Date Signed: 07/08/2026 10:03:16 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
05/18/2026 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20260518125925
FACILITY NAME:CARLTON SENIOR LIVING ORANGEVALEFACILITY NUMBER:
345002805
ADMINISTRATOR:DIRAR, EMANUELFACILITY TYPE:
740
ADDRESS:8773 OAK RDTELEPHONE:
(916) 988-2200
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:136CENSUS: 83DATE:
07/08/2026
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Emanuel Dirar, AdministratorTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff did not administer prescribed medication to a resident in care.
INVESTIGATION FINDINGS:
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On 7/8/26, Licensing Program Analyst (LPA) Talwinder Bains arrived unannounced to deliver complaint findings for allegations listed above. LPA met with Administrator,Emanuel Dirar during today's visit and explained the purpose of the visit.
The department conducted record review, interviewed staff and residents to investigate this allegation. Record review indicated that resident, R1 have scheduled colonoscopy for 5/14/26. Staff received instructions from R1s medical professionals regarding certain medications which need to be held due to the procedure. Staff failed to contact R1s ophthalmologist regarding R1s eye drops due to the procedure. Record review and staff interviews reflected that staff did not administer R1’s glaucoma medication (eye drops) on 5/14/26 without consulting R1’s ophthalmologist. Interview with resident, R1 indicated that staff held their glaucoma medication on 5/14/26 without permission from their Ophthalmologist.Based on the information gathered, the preponderance of evidence standards has been met, therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiency is being cited on the attached LIC 9099-D page.

Exit interview conducted. Appeal rights and a copy of this report were provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
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 59-AS-20260518125925
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CARLTON SENIOR LIVING ORANGEVALE
FACILITY NUMBER: 345002805
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/22/2026
Section Cited
CCR
80075(b)(5)(B)
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80075 -Health Related Services (b)(5)(B) - Once ordered by the physician the medication is given according to the physician's directions.... This requirement was not met as evidenced by:
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Administrator agreed to submit a self certification for this regulation and will do training for all staff regarding medication administration and submit proof to LPA by POC date-7/22/26.
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Based on incident report, staff interviews and medication record review from the facility, It was determined that staff did not administer eye drops to R1 which poses a potential health and safety risks to residents in care.
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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: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2