Complaint Investigation Report

345920066-5-20-2026-59-AS-LMUZ-DUAN2K-20260521100450

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO NORTH ASC , 9835 GOETHE ROAD, SUITE 100

This is an official report of an unannounced visit/investigation of a complaint received in our office on

05/15/2026 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20260515101111

Licensee does not keep accurate personnel records.

Licensing Program Analyst (LPA) Talwinder Bains arrived at the care home today and met with the Administrator, Sefora Niculai to open and deliver complaint investigation findings regarding the above stated allegation.

During today's visit, LPA conducted interviews and reviewed documentation pertinent to the investigation. LPA reviewed all staff files and found all staff to be criminal background cleared and to have complete personnel files. Interviews with Administrators and staff (S1 and S2) indicated that the staff working in the care home matched the Personnel Report LIC500.

Based on documentation obtained and interviews conducted, the above allegations are found to be UNFOUNDED. A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or are without a reasonable basis. No deficiencies are being cited.

Exit interview conducted. A copy of the report was provided.