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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 037001001
Report Date: 09/24/2026
Date Signed: 09/24/2026 01:41:22 PM

Substantiated


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
08/19/2026 and conducted by Evaluator Kimberly Viarella
COMPLAINT CONTROL NUMBER: 27-AS-20260819111921
FACILITY NAME:GOLD QUARTZ INN RETIREMENT HOMEFACILITY NUMBER:
037001001
ADMINISTRATOR:LOREEN HICKMANFACILITY TYPE:
740
ADDRESS:15 BRYSON DRIVETELEPHONE:
(209) 267-9155
CITY:SUTTER CREEKSTATE: CAZIP CODE:
95685
CAPACITY:47CENSUS: 33DATE:
09/24/2026
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Brandee Butler, Assistant Executive Director/DesigneeTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff did not safeguard residents personal belongings.
INVESTIGATION FINDINGS:
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On 09/24/26, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to deliver the findings of the investigation into the above allegation. LPA identified herself upon arrival stated the purpose of the visit, and asked to meet with the designated facility administrator /Executive Director (ED), Loreen Hickman. Hickman was not scheduled to work today and this LPA met with the Assistance Executive Director/Designee, Brandee Butter.

Regarding:
Staff did not safeguard residents personal belongings.

Based on interviews with the resident (R1) the Ombudsman (O1), and the Designee, on September 24, 2025 after taking R1 to an appointment, the Gold Quartz transport driver, (S1), and R1 returned to R1's previous residence to remove the remainder of their belongings. According to R1, Items included but were not limited to: their children's baby books, a collection of antique Bibles from the
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
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 6
Control Number 27-AS-20260819111921
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: GOLD QUARTZ INN RETIREMENT HOME
FACILITY NUMBER: 037001001
VISIT DATE: 09/24/2026
NARRATIVE
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1800's, investments/accumulation career awards, Videos, CD's & DVD's, memorabilia, photo albums and professional catalogs and letters of recommendations.

Some of these items were delivered to R1's room, the remainder were left in the community's van. R1 stated that S1 told them that they would be brought to R1's room the following day. According to an interview with S1, the remainder of R1's belongings were brought to their room the following day, except for the books. S1 stated that moving from a house to a room meant that R1 was having hard time finding space for everything. S1 told this LPA that R1 said they wanted to donate their books to the facility library so S1 brought the books there.

Approximately a week later, R1 asked about the books again and S1 said they were no longer in the library. R1 wanted to know what happened to the books. S1 said they would try and find out. According to R1, they continued to ask staff. On 10/17/25, R1 stated that Staff (S3) and (S4) went to R1's room and informed R1 that their belongings were brought to various charities.

When this LPA interviewed S3, they stated that while walking through the library, they saw several trash bags in the corner. S3 said that S1 happened to be walking by and asked if S1 knew what they were. S3 stated that they were told by S1 that R1 donated the books. S3 told this LPA that they didn't usually take donations and only kept large print books in the library. S3 stated that they instructed maintenance to "remove them." An interview with maintenance worker (S2) confirmed that they threw the books away. S3 told this LPA that they "took full responsibility for the mistake."

S2 also stated that the items they disposed of that day were books, but previously on at least one other occasion, R1 had requested that S2 throw away other boxes that R1 had been storing on their porch and some of them contained pictures. S2 stated that they remembered "because people usually do not want to throw those out."

The standard for the preponderance of evidence has been met and the Department found the allegation, "Staff did not safeguard residents personal belongings," SUBSTANTIATED.

An inventory of R1's belongings was not conducted as required per Theft and Loss regulation 87218(a)(1).
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
08/19/2026 and conducted by Evaluator Kimberly Viarella
COMPLAINT CONTROL NUMBER: 27-AS-20260819111921

FACILITY NAME:GOLD QUARTZ INN RETIREMENT HOMEFACILITY NUMBER:
037001001
ADMINISTRATOR:LOREEN HICKMANFACILITY TYPE:
740
ADDRESS:15 BRYSON DRIVETELEPHONE:
(209) 267-9155
CITY:SUTTER CREEKSTATE:CAZIP CODE:
95685
CAPACITY:47CENSUS: 33DATE:
09/24/2026
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Brandee Butter, Assistant Ececutive Director/DesigneeTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff gave away resident's belongings without consent.
INVESTIGATION FINDINGS:
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On 09/24/26, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to deliver the findings of the investigation into the above allegation. LPA identified herself upon arrival stated the purpose of the visit, and asked to meet with the designated facility administrator/Executive Director (ED), Loreen Hickman. Hickman was not scheduled to work today and this LPA met with the Assistanct Executive Director/Designee, Brandee Butler.

Regarding:
Staff gave away resident's belongings without consent.

During the course of this investigation, it was learned that a Resident's (R1's) personal belongings were not inventoried and were thrown away without their consent. The facility did not "give them away" therefore the standard for the preponderance of evidence was not met. The Department found the above allegation to be UNSUBSTANTIATED. A finding of unsubstantiated means that the allegation may have
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 27-AS-20260819111921
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: GOLD QUARTZ INN RETIREMENT HOME
FACILITY NUMBER: 037001001
VISIT DATE: 09/24/2026
NARRATIVE
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happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Staff, S3, told this LPA to ordering S2 to remove of the books that they knew belonged to R1. Neither staff member were aware that R1 had been requesting the books and wanted them back. This personal rights violation will be conducted in a case management visit following this one.

According to the California Code of Regulations, Title 22, no other deficiencies were cited during today's visit, a copy of this report was provided and an exit interview was conducted with Brandee Butler.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6
Control Number 27-AS-20260819111921
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: GOLD QUARTZ INN RETIREMENT HOME
FACILITY NUMBER: 037001001
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/16/2026
Section Cited
CCR
87218(a)(1)
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Theft & Loss (a) The licensee shall adequate theft & loss program as specified in HSC 1569.153. (1) The initial personal property inventory shall be completed by the licensee, and the resident, or the resident’s representative.
The Licensee did not meet the above requirement when:
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Designee stated that will obtain an inventory of R1's property and an audit of all other resident files to see if any inventories are missing or need updating. These will be completed by close of business on 10/16/26. Copies of both will be sent attention to Kimberly Viarella at
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Based on interviews and document review, the licensee did not ensure that an inventory was completed upon move-in to establish and safeguard the resident's personal belongings. This posed a potential threat to the health, safety, and personal rights of residents in care.
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CCLASCPSacrametoSouthRO@dss.ca.gov
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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.
SUPERVISOR'S NAME: Lisa Rios
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 27-AS-20260819111921
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: GOLD QUARTZ INN RETIREMENT HOME
FACILITY NUMBER: 037001001
VISIT DATE: 09/24/2026
NARRATIVE
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This deficiency was cited on the LIC 9099D page. If an inventory had been completed, there would have been documentation regarding what may or may not have been donated.

According to the California Code of Regulations, Title 22, no other deficiencies were cited during today's visit and a copy of this report was provided and an exit interview conducted with Brandee Butter,
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6