347005361-7-21-2026-27-AS-CVAO-DW7VHS-20260721162736

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 347005361
Report Date: 07/21/2026
Date Signed: 07/21/2026 04:27:46 PM

Document Has Been Signed on 07/21/2026 04:27 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	SUMMERSET ASSISTED LIVING		FACILITY NUMBER:	347005361
ADMINISTRATOR/ DIRECTOR:	ERICA DIALA		FACILITY TYPE:	740
ADDRESS:	2341 VEHICLE DR		TELEPHONE:	(916) 330-1300
CITY:	RANCHO CORDOVA	STATE: CA	ZIP CODE:	95670
CAPACITY: 135		CENSUS: 103	DATE:	07/21/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:20 PM
MET WITH:	Erica Diala		TIME VISIT/ INSPECTION COMPLETED:	05:00 PM

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	Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct an annual required inspection. LPA Valerio met with Administrator Erica Diala, and explained the purpose of the visit. LPA Valerio and Administrator Erica toured the facility to ensure compliance with Title 22 regulations. LPA Valerio observed all floors of the building and inspected eight (8) bedrooms. All bedrooms were observed to have their own bathroom/shower. 7 out of 8 residents rooms were observed to clean, fully furnished, and exit doorsways were free from obstructions. One resident bathroom was observed to have blood stains in the bathroom. According to Administrator, the resident has dialysis and sometimes has leakage of blood. Administrator stated, housekeeping would clean the floors. LPA Valerio inspected the hallways, laundry room, kitchen area, and dinning room. No health or safety concerns observed on the floor. The fire extinguishers located in the hallway were observed to be fully charged with the last date of inspection on July 9, 2026. The second floor is the memory care area. The elevator was observed to be in working condition. During the tour, LPA Valerio smelled an odor on the second floor. Staff explained that a resident had an accident and was taken to take a shower. All areas were observed to be free from hazardous items accessible to residents in care. LPA Valerio observed residents and staff engaging in a shark craft activity. LPA Valerio observed the third floor of the facility. This floor is considered the "independent living" floor. LPA Valerio observed no odors and the common areas to be fully furnished. Continues on LIC 809 - C...

Stephen Richardson
Christina Valerio
	DATE: 07/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SUMMERSET ASSISTED LIVING	FACILITY NUMBER: 347005361
	VISIT DATE: 07/21/2026

NARRATIVE

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LPA Valerio observed the laundry rooms to have washers that were not in good repair. The facility was cited on a subsequent visit for complaint 27-AS-20260714174144 on today's date of 07/21/2026.

LPA Valerio observed the main kitchen area. LPA Valerio observed the food supply. LPA Valerio observed lunch to be the following: beef and cheese quesadilla, Spanish rice, refried beans, turkey & rice Soup, and assorted dessert. LPA Valerio observed pie being offered for dessert. For dinner, the menu stated the residents would be served breaded veal cutlet, mash potatoes with gravy, broccolini, turkey & rice soup, and pie. In the Assisted Living (AL) dining room area, LPA Valerio observed an all day breakfast menu, which can be ordered as a second option. All day breakfast items include: pancakes, waffle, French toast, avocado toast, breakfast sandwich, omelets, assorted cereals, toasted bread, bacon, eggs, ham, hash browns, sausages, applesauce, fruit, pudding, and yogurt. LPA Valerio observed the lobby area to have apples and oranges next to the coffee bar.

LPA Valerio reviewed facility files, which were observed to current with up to date annual documentation. The date of the last fire drill was on July 13, 2026

LPA Valerio requested the following annual documentation be sent to christina.valerio@dss.ca.gov:
- LIC 500
- LIC 308
- LIC 610D
- Copy of Liability Insurance

Per California Code of Regulation (CCR) - Title 22 - no deficiencies were cited on this visit. An exit interview was held, and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Stephen Richardson
NAME OF LICENSING PROGRAM ANALYST: Christina Valerio
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2026

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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