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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700835
Report Date: 07/08/2026
Date Signed: 07/08/2026 03:17:04 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
06/08/2026 and conducted by Evaluator Pang Lee
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260608195000
FACILITY NAME:CITY CREEK ASSISTED LIVINGFACILITY NUMBER:
342700835
ADMINISTRATOR:CALEB SUMMERHAYSFACILITY TYPE:
740
ADDRESS:6254 66TH AVENUETELEPHONE:
(916) 393-2324
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:121CENSUS: 113DATE:
07/08/2026
UNANNOUNCEDTIME BEGAN:
02:23 PM
MET WITH:Katelyn FloresTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
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8
9
Staff hit resident.
Staff pushed resident.
INVESTIGATION FINDINGS:
1
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13
On 07/08/2026, Licensing Program Analysts (LPAs) Pang Lee, Reza Jamaly, and Kimberly Kulich conducted an unannounced visit to the facility. Upon arrival, the LPAs met with Health Services Director (HSD) Katelyn Flores and explained the purpose of the visit. The purpose of the visit was to deliver the findings related to the allegations above. At the time of the visit, the facility census was 113.

It was alleged that staff hit resident and that staff pushed resident. This investigation consisted of interviews with residents, facility staff, and an outside agency, observations, and a review of facility records. LPA interviewed eight out of nine residents. All eight residents denied being hit or pushed by facility staff, reported having no concerns related to the allegations, and stated that they felt safe living at the facility. During an interview with R1, R1's statements were inconsistent and conflicting, and no clear disclosure was made to support the allegations.
CONTINUED LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Arielle Pascua
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
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-20260608195000
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: CITY CREEK ASSISTED LIVING
FACILITY NUMBER: 342700835
VISIT DATE: 07/08/2026
NARRATIVE
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LPA also interviewed six out of six staff members. All staff denied the allegations and stated that they had never witnessed facility staff hit or push any residents in care. An interview with an outside agency (OA) also revealed no concerns regarding the allegations. The OA reported that they had never witnessed facility staff hit or push residents and had not received any reports from residents alleging such conduct. During multiple visits to the facility, LPA Lee did not observe any interactions in which staff hit or pushed residents, nor did any residents report concerns regarding physical abuse by facility staff. A review of facility records identified six incident reports dated between December 29, 2025, through June 7, 2026. None of the reports documented any incident involving staff hitting or pushing resident 1 (R1). Additionally, a review of facility personnel records, Licensing Information System (LIS) Facility Personnel Report Summary and the Guardian Background Check System confirmed that there is no current or former employee by the name of Staff 1 (S1) associated with the facility. Based on the interviews conducted, observations made, and records reviewed, there is insufficient evidence to support the allegation that facility staff hit and pushed residents.

As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegation may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with (HSD) Katelyn Flores and a copy of this report was provided to the facility.
SUPERVISORS NAME: Arielle Pascua
LICENSING EVALUATOR NAME: Pang Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
LIC9099 (FAS) - (06/04)
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