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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701251
Report Date: 06/04/2026
Date Signed: 06/15/2026 09:16:43 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 Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260203145929
FACILITY NAME:SIERRA LOMA ASSISTED LIVINGFACILITY NUMBER:
342701251
ADMINISTRATOR:ILONA CORPUSFACILITY TYPE:
740
ADDRESS:3950 ANNADALE LANETELEPHONE:
(916) 489-6900
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:94CENSUS: 70DATE:
06/04/2026
UNANNOUNCEDTIME BEGAN:
01:44 PM
MET WITH:Kyle Riley DONTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Facility staff did not keep residents' health care confidential.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Albert Johnson conducted an unannounced complaint investigation at Sierra Loma Assisted Living RCFE on 6/4/26 to deliver findings for the complaint allegation mentioned above.

Based on interviews and records review, the allegation that staff failed to maintain resident confidentiality and made inappropriate, derogatory statements about a resident’s health condition is unsubstantiated. Resident (R1) reported that staff member (S1) discussed her private health information in a public hallway where other staff could hear. R1 stated that S1 told staff that R1 “always has UTIs,” “is bleeding,” and made a derogatory comment that R1 “has an ugly face.” R1 reported that MedTech (S2) was present and witnessed S1 making these statements. Continued
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
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 2
Control Number 27-AS-20260203145929
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: SIERRA LOMA ASSISTED LIVING
FACILITY NUMBER: 342701251
VISIT DATE: 06/04/2026
NARRATIVE
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Interviews with S2 corroborated that S1 discussed R1’s health condition in a non-private area and made inappropriate remarks. S1 denied making derogatory comments and denied discussing R1’s health condition “in passing” with other staff.
S3 could not remember hearing information about R1's health condition and did not deny that it may have happen. S3 stated that they could not recall witnessing anything that S1 may have said about R1 at anytime that S1 was employed with the facility.

The department has investigated the allegation that the facility staff did not keep residents' health care confidential. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, and therefore the allegation is unsubstantiated. An exit interview was conducted, and a copy of this report was provided to the facility.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2