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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345002909
Report Date: 03/20/2026
Date Signed: 03/20/2026 04:53:04 PM

Unsubstantiated


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
06/23/2025 and conducted by Evaluator Cassie Yang
COMPLAINT CONTROL NUMBER: 59-AS-20250623112243
FACILITY NAME:COGIR OF FOLSOMFACILITY NUMBER:
345002909
ADMINISTRATOR:TAYLOR, DEBORAHFACILITY TYPE:
740
ADDRESS:1801 EAST NATOMA STREETTELEPHONE:
(916) 608-0800
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:66CENSUS: DATE:
03/20/2026
UNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Liz CruzTIME COMPLETED:
04:55 PM
ALLEGATION(S):
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Staff are not taking steps to prevent the spread of a communicable disease.
Staff are not following proper food safety protocols with residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to delivered the findings of the allegations cited above. LPA met with Exceutive Director and explained the purpose of the visit.

For the allegation of Staff are not taking steps to prevent the spread of a communicable disease, based on information obtained facility did not have a policy restricting residents from having visitors to prevent the spread of a communicable disease. Interview conducted with Executive Director revealed that staff wears masks to prevent spread, along with complying with proper hand hyigene and cleaning. But residents are not required to if refused. Due to most residents' cognitive impairment, some resident refused isolation.

For the allegation of Staff are not following proper food safety protocols with residents in care, based on information obtained, kitchen staff are required to follow proper hand washing protocol. The alleged incident occurred was in reference to a hamburger being undercooked but there are no evidence of the alleged event. Please continue on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026
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-20250623112243
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: COGIR OF FOLSOM
FACILITY NUMBER: 345002909
VISIT DATE: 03/20/2026
NARRATIVE
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LIC 9099-C

Interview conducted with Executive Director revealed that hamburger at the facility may be served a certain way but request of the resident. Interview conducted with resident (R1) revealed that R1 cannot recalled being served undercooked hamburger. With the information obtained, the allegations are unsubstantiated.

As a result of this investigation, it was determined the allegations are to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is no preponderance of evidence to prove that the alleged violation occurred.

Exit interview and a copy of the report was provided.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2