347000985-1-9-2026-27-AS-SRIN-DQLVPQ-20260123153706

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347000985
Report Date: 01/09/2026
Date Signed: 01/09/2026 10:20:02 AM

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
12/31/2025 and conducted by Evaluator Christina Valerio

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20251231092021

FACILITY NAME:	GOLDEN POND RETIREMENT COMMUNITY		FACILITY NUMBER:	347000985
ADMINISTRATOR:	RYAN NAKAO		FACILITY TYPE:	740
ADDRESS:	3415 MAYHEW ROAD		TELEPHONE:	(916) 369-8967
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95827
CAPACITY:	175	CENSUS:	DATE:	01/09/2026
		UNANNOUNCED	TIME BEGAN:	07:00 AM
MET WITH:	Ryan Nakao		TIME COMPLETED:	10:40 AM

ALLEGATION(S):

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Staff does not ensure to follow proper food safety policies

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a complaint investigation and deliver findings. LPA Valerio met with Administrator Ryan Nakao, and explained the purpose of the visit.

The following has been determined as it relates to the aforementioned allegation.

On 12/31/2025, the Regional Office was notified that the facility allegedly does not follow proper food safety protocols by allowing diary products, such as creamer, and juice to sit out in the morning for hours at a time. It was alleged that the facility kitchen lead staff and management have known for years and do nothing about it.

LPA Valerio was sent multiple pictures on 01/02/2026, 01/05/2026, and 01/06/2026.
Continues on LIC 9099 - C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026

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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Control Number 27-AS-20251231092021

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: GOLDEN POND RETIREMENT COMMUNITY	FACILITY NUMBER: 347000985
	VISIT DATE: 01/09/2026

NARRATIVE

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On January 2, 2025, a picture of a table with a set of dinning utensils, white coffee cup, and a small 2oz stainless steel container with creamer was sent to LPA Valerio. According to the RP, the picture was taken around 7:00 AM and breakfast did not start until 8:00 AM. On January 4, 2025, a picture was sent to LPA of a dining table with the table set (paper placemat, rolled up utensils, a white coffee cup, and two small 2 oz stainless steel cup filled with creamer). There was a large clock in the background, which showed the time of 7:05 AM. On January 5, 2025, a picture of 20+ unfilled glass cups and 1 glass cup filled with juice was sent to LPA. The juice was said to be prune juice, which was pre-poured before residents arrived for breakfast. The picture was sent to LPA at 8:56 AM; however, it was reported that it was taken around 7:00 AM.

LPA Valerio conducted two unannounced visits on 01/06/2025 and 01/09/2025. On 01/06/2025, LPA Valerio observed lunch service. Drink products were observed to be on ice. The salad prep area was observed to be on ice. Staff were observed to be cleaning, serving residents, and wearing hair nets while in the kitchen. LPA Valerio observed food products to be of good quality and unexpired. LPA observed an adequate supply of perishable food items. LPA Valerio observed the kitchen to be clean. LPA Valerio observed kitchen staff to have up to date Food Handler certificates. On 01/09/2025, LPA Valerio observed breakfast service. LPA Valerio observed creamer and diary products to be on ice. LPA Valerio observed fruit and vegetables that were prepped for breakfast being put on ice.

According to interviews conducted with staff, staff deny the allegations being true. Staff expressed following food safety protocols. It was reported that residents come down as early as 6:30 AM; however, breakfast service does not start until 7:30 AM. For the residents that come down early to wait, serving staff will provide coffee. According to interviews with residents, there were no concerns disclosed and expressed being happy with the food service.

Based on all the information collected by the Department, although the allegation may have happened or is valid, here is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited. An exit interview was held, and a copy of report was left at the facility.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2026

LIC9099 (FAS) - (06/04)

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