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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347000985
Report Date: 02/04/2026
Date Signed: 02/04/2026 03:30:09 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
02/03/2026 and conducted by Evaluator Christina Valerio
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260203091728
FACILITY NAME:GOLDEN POND RETIREMENT COMMUNITYFACILITY NUMBER:
347000985
ADMINISTRATOR:RYAN NAKAOFACILITY TYPE:
740
ADDRESS:3415 MAYHEW ROADTELEPHONE:
(916) 369-8967
CITY:SACRAMENTOSTATE: CAZIP CODE:
95827
CAPACITY:175CENSUS: 84DATE:
02/04/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ryan NakaoTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff do not ensure facility is cleaned properly
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a complaint investigation. LPA Valerio met with Administrator Ryan and explained the purpose of the visit.

It was alleged that the facility does not clean properly. The facility staff leave garbage cans in the hallway, do not vacuum, and the walls are greasy.

LPA Valerio toured the facility for personal observation and to conduct interviews. LPA observed 3 housekeeping staff and one person doing laundry. LPA Valerio observed housekeeping staff cleaning bedrooms, cleaning the carpets, and vacuuming the hallways. LPA observed housekeeping carts to have cleaning supplies, hygiene supplies, and an area to throw away garbage. LPA did not observe any garbage in the hallways. The walls did not feel greasy. The common areas appeared to be clean and free from odors.
Continues on LIC 9099 - C...

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026
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-20260203091728
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: 02/04/2026
NARRATIVE
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Bedroom 1: The apartment was fully furnished with no odors. LPA saw a sign on the door that stated that laundry and housekeeping was scheduled for Tuesday for their room. LPA did not observe any dust on their china cabinet that housed items and picture frames. LPA Valerio observed the two bedrooms to be clean without odors. The beds were fully made. There were no clutters. LPA observed the kitchen to be clean without any hazardous items and no dirty dishes.
Bedroom 2: Bedroom was a one bedroom apartment. their was no clutter, the bed was made, and their were no odors.
Bedroom 3: LPA Valerio observed the bedroom. It is a one bedroom apartment. LPA did not smell any odors. LPA observed the room to have clean floors and the beds were made.
Bedroom 4: LPA Valerio observed the room to have a distinct bodily fluid smell. However, the room was not cluttered and the bathroom was cleaned. The resident in the room appeared to be content and happy with the facility. Administrator stated that they have cleaned the room by adding extra cleaning days, implemented a shampoo carpet cleaning, and updating the conservator regarding the status of the condition.
Bedroom 5: This bedroom was observed to have a cat. LPA did not feel like the bedroom smelled like cat litter. The bed was not made but it appeared that the resident may have just left for lunch service. The living room area was well kept.
Bedroom 6: LPA Valerio observed the studio apartment to be fully furnished. The room was observed to have multiple cups and To go food trays near the door way and by the resident's bedside. The administrator stated that the resident prefers that these are left there because the resident wants to keep them. The staff will come in and tell the resident they need to clean it up and the resident will allow it at times. The staff will come take the garbage out and inform the resident that it is unsafe to keep food from the previous day.
Bedroom 7: LPA Valerio observed his room to be clean without odors. His room was set at a cooler temperature. There were no signs of clutter. The room appeared to be freshly vacuumed as evidenced by the vacuum lines on the carpet. The bathroom did not have any stains. The rugs did have dark stains on a small section near the front entrance where people enter the bedroom.

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: 02/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026
LIC9099 (FAS) - (06/04)
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