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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455002996
Report Date: 09/02/2025
Date Signed: 09/02/2025 11:14:25 AM

Substantiated


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
08/22/2025 and conducted by Evaluator Rebecca Knight
COMPLAINT CONTROL NUMBER: 59-AS-20250822162325
FACILITY NAME:ANDERSON CREEK SRFFACILITY NUMBER:
455002996
ADMINISTRATOR:THRUSH, TIAFACILITY TYPE:
772
ADDRESS:1901 BARNEY ROADTELEPHONE:
(916) 870-9676
CITY:ANDERSONSTATE: CAZIP CODE:
96007
CAPACITY:14CENSUS: 12DATE:
09/02/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Larry Tanner - administratorTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Facility not meeting hygiene needs. - SUBSTANTIATED
INVESTIGATION FINDINGS:
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09/02/2025 10:00 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a complaint investigation. LPA met with administrator Larry Tanner and explained the purpose of the visit.

During the visit LPA intervewed the administrator and reviewed documents.

Continued on LIC9099-C

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
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 5
Control Number 59-AS-20250822162325
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: ANDERSON CREEK SRF
FACILITY NUMBER: 455002996
VISIT DATE: 09/02/2025
NARRATIVE
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Facility not meeting hygiene needs. - SUBSTANTIATED

It was reported that three clients have long, unkempt toenails.

LPA reviewed photographs of three clients feet. The photographs show Client 2 (C2) and Client 3 (C3) have long toenails and Client 1 (C1) has extremely long toenails. LPA reviewed LIC602 Physician's Report for C1 which shows that C1 has lived in the facility for slightly more than six weeks. C1 resided in a sister facility licensed by the same licensee prior to living in this facility.

Administrator stated that after the condition of C1's toenails were brought to their attention, C1 was taken to Urgent Care who then referred C1 to a podiatirist who denied the referral. C1 was then taken to ER for treatment. C1's toenails were trimmed in the ER on 08/26/2025. The administrator gave C2 and C3 their own set a clippers and both clients have trimmed their toenails and are satisfied with the results.

It was determined that C1 has been lving at the facility for more than 6 weeks and staff did not ensure that their toenails were properly taken care of. This allegation is substatiated.

Based on interviews and evidence obtained during the investigation, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22), is being cited on the attached LIC9099D. Appeal rights were provided. Exit interview conducted and a copy of the report was provided to administrator Larry Tanner.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 59-AS-20250822162325
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: ANDERSON CREEK SRF
FACILITY NUMBER: 455002996
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2025
Section Cited
CCR
80075(a)
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80075(a) Health Related Services (a)The licensee shall ensure that each client receives necessary first aid and other needed medical or dental services, including arrangement for and/or provision of transportation to the nearest available services.This requirement was not met as evidenced by:
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Licensee agrees to develop a program which will include an examiniation of client's feet upon admission to the facility to ensure that there are not unmet foot hygeine issues that need to be addressed.
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Based on interviews and record review the facility failed to ensure that 3 of 12 clients had their toenails maintained.
This poses a potential Health, Safety and Personal Rights risk to residents in care.
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Licensee shall submit the plan to LPA as proof of correction.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
08/22/2025 and conducted by Evaluator Rebecca Knight
COMPLAINT CONTROL NUMBER: 59-AS-20250822162325

FACILITY NAME:ANDERSON CREEK SRFFACILITY NUMBER:
455002996
ADMINISTRATOR:THRUSH, TIAFACILITY TYPE:
772
ADDRESS:1901 BARNEY ROADTELEPHONE:
(916) 870-9676
CITY:ANDERSONSTATE: CAZIP CODE:
96007
CAPACITY:14CENSUS: 12DATE:
09/02/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Larry Tanner - administratorTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
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9
Facility not seeking medical attention in a timely manner. - UNSUBSTANTIATED
INVESTIGATION FINDINGS:
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09/02/2025 09:30 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a complaint investigation. LPA met with administrator Larry Tanner and explained the purpose of the visit.

During the visit LPA intervewed the administrator and reviewed documents.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 59-AS-20250822162325
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: ANDERSON CREEK SRF
FACILITY NUMBER: 455002996
VISIT DATE: 09/02/2025
NARRATIVE
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Facility not seeking medical attention in a timely manner. - UNSUBSTANTIATED

It was reported that three clients have toenail fungus and have not been treated by their physicians.

Administrator stated that they held a meeting with all clients and asked about their toes and feet. The administrator distributed a pair of heavy duty toenail clippers to each individual client and asked how they felt about their toenails. Client 4 (C4) requested to be examined by their physician who did not diagnose a nail fungus. Client 5 (C5) and Client 6 (C6) did not request to go to their doctors to be examined.

It was determined that there is not enough evidence to support that the three clients have a nail fungus. Client 4 (C4) was taken to see their physician and was not diagnosed with a nail fungus. This allegation is unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED. No deficiencies cited. Exit interview conducted and a copy of the report was provided to administrator Larry Tanner.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5