345002909-4-3-2026-59-AS-LMUZ-DT7U7R-20260416152021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345002909
Report Date: 04/03/2026
Date Signed: 04/03/2026 03:55:35 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
01/08/2026 and conducted by Evaluator Angela Hood

COMPLAINT CONTROL NUMBER: 59-AS-20260108215802

FACILITY NAME:	COGIR OF FOLSOM		FACILITY NUMBER:	345002909
ADMINISTRATOR:	CRUZ, ELIZABETH		FACILITY TYPE:	740
ADDRESS:	1801 EAST NATOMA STREET		TELEPHONE:	(916) 608-0800
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	66	CENSUS: 41	DATE:	04/03/2026
		UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Liz Cruz, Executive Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

-Staff did not maintain the facility HVAC system in good repair
-Staff do not provide appropriate care and supervision for a cognitively impaired resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Angela Hood arrived at the care home today and met with the Executive Director, Liz Cruz, to deliver complaint investigation findings regarding the above stated allegations.

Allegation: Staff did not maintain the facility HVAC system in good repair
On January 14, 2026, LPA and the Local Long-Term Care Ombudsman (LTCO) conducted a joint visit and toured the care home, as well as resident (R1’s) room. The facility has an HVAC system that operates throughout all hallways and common areas and PTAC units in each residents’ room. LPA and LTCO observed all thermostats throughout the facility hallways and common areas, as well as a PTAC on the wall in one hallway. All thermostats appeared to be functioning and the facility temperatures were observed to be within regulatory range. LPA and LTCO observed that the window was open in R1’s room, the PTAC on the wall was not turned on, and the PTAC was plugged in. LPA and LTCO observed that

*************************************************Continued on LIC9099-C****************************************************

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026

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-20260108215802

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: 04/03/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

the PTAC in R1’s room was functioning and had a temperature range that could be adjusted between 60-86 degrees F. LPA and LTCO attempted to interview R1, who did not express any concerns regarding the PTAC and indicated that it works. Interviews with the Executive Director (ED) and Maintenance Director (MD) indicated that the PTAC in R1’s room had been replaced as well as the filter. MD also indicated that the PTAC temperatures have a specific range to ensure safety of residents operating the units.

Allegation: Staff do not provide appropriate care and supervision for a cognitively impaired resident
Interviews with staff (S1 and S2) indicated that they provide care and supervision to residents in R1’s wing of the facility. S1 indicated that R1 opens and closes their window throughout the day. S1 and S2 indicated that staff are notified when a resident opens their window. S2 indicated that if a resident wants their window open and it is the appropriate temperature outside, staff will keep it open. S1 and S2 indicated they will adjust the PTAC, if needed, during resident checks or upon request to ensure residents' rooms remain at a comfortable temperature. S1 and S2 indicated that they believe the facility provides good care and supervision to the residents and that they have enough staff per resident to provide monitoring. S1 indicated that staff will provide checks on residents every two (2) hours. S1 and S2 indicated that most residents will be in the common areas throughout the day. ED indicated that the facility has enough staff on schedule to provide care and supervision for the residents. LPA has been receiving monthly schedules from the facility indicating the facility is fully staffed during all shifts.

Based on observations made, interviews conducted, and documentation obtained, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are UNSUBSTANTIATED. No deficiencies are being cited.
Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 2