342700090-5-20-2026-27-AS-SRIN-DUM9SR-20260531233758

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700090
Report Date: 05/20/2026
Date Signed: 05/20/2026 04:03:51 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
02/06/2026 and conducted by Evaluator Arvin Villanueva

COMPLAINT CONTROL NUMBER: 27-AS-20260206125137

FACILITY NAME:	ELK RIDGE OAKS		FACILITY NUMBER:	342700090
ADMINISTRATOR:	LOVELIE P ARCEGA		FACILITY TYPE:	740
ADDRESS:	8724 ELK RIDGE WAY		TELEPHONE:	(916) 667-9521
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	6	CENSUS: 6	DATE:	05/20/2026
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Monalisa Silapan		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff neglect led to resident's hospitalization.

INVESTIGATION FINDINGS:

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On May 20, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived at this facility unannounced to conduct a follow-up complaint investigation visit and to deliver findings regarding the allegation noted above. LPA initially met with staff on duty and stated the purpose of the visit. The administrator, Monalisa Silapan (AD) was notified and arrived shortly after. Present during this visit were six residents in care with two staff on duty.

The investigation into the above allegation consisted of interviews with relevant individuals and reviews of relevant records pertaining to Resident-1, (R1).

Interviews with staff members revealed that on January 23, 2026, R1 was seen between 8:30am and 9:00am and later returned to the bedroom to nap. Staff stated R1 did not require supervision while sleeping in the bedroom. Staff reported hearing R1 yell and later found R1 on the floor at about 10:00am.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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-20260206125137

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: ELK RIDGE OAKS	FACILITY NUMBER: 342700090
	VISIT DATE: 05/20/2026

NARRATIVE

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Interviews with residents in care who stated they did not have concerns about the care provided at this facility.

Review of relevant records showed that R1 was transported to the emergency hospital on January 23, 2026, after an unwitnessed fall that occurred while at this facility. Medical records documented that R1 suffered facial injuries, swelling, and traumatic subdural hematoma. Records also showed that R1 had a history of dizziness, weakness, cognitive impairment and was considered a fall risk. Facility records documented that R1 used walkers and wheelchairs and required assistance with mobility. Additionally, records did not indicate R1 requires one-to-one care or supervision while sleeping in their room.

Although R1 suffered a serious injury after the fall, interviews and record reviews did not show that facility staff neglected or failed to provide the required supervision and care. Records showed staff were aware of R1’s care needs and that R1 was ambulatory and able to rest/sleep in their bedroom without continuous supervision.

Based on the information gathered throughout this investigation, there was insufficient evidence to prove the allegation that neglect/lack of care and supervision resulted in R1 being hospitalized. Therefore, the allegation was unsubstantiated.

Note that aA finding that the complaint allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Monalisa, and a copy of this report and appeal rights were provided.

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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC9099 (FAS) - (06/04)

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