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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 092700822
Report Date: 03/03/2026
Date Signed: 03/03/2026 11:32:24 AM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
12/08/2025 and conducted by Evaluator Lavinia Muscan
COMPLAINT CONTROL NUMBER: 59-AS-20251208103213
FACILITY NAME:BLISSFUL GARDENFACILITY NUMBER:
092700822
ADMINISTRATOR:SOKIMI, MOTUOMANONOFACILITY TYPE:
740
ADDRESS:4210 PRODUCT DRIVETELEPHONE:
(530) 313-0364
CITY:CAMERON PARKSTATE: CAZIP CODE:
95682
CAPACITY:46CENSUS: 39DATE:
03/03/2026
UNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Administrator Motu SokimiTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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9
Staff abused resident in care
Staff restrained resident in care
Staff yelled at residents in care
INVESTIGATION FINDINGS:
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On 3/3/26, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator Motu Sokimi.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

**Report continued on 9099-C**
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
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 59-AS-20251208103213
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: BLISSFUL GARDEN
FACILITY NUMBER: 092700822
VISIT DATE: 03/03/2026
NARRATIVE
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Staff abused resident in care
Staff restrained resident in care
The Department conducted interviews with staff members and reviewed records regarding allegations above. Staff interviews revealed that they were not aware of any abuse or restraining of any residents in care; therefore, the above allegations are found to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Staff yelled at residents in care
The department interviewed six (6) staff during a complaint investigation. The department conducted a tour of the facility on 12/08/25 and 02/17/26. Interviews indicated that all staff treat all residents with dignity and respect and do not yell at residents. During a facility tour on 12/08/25 and 02/17/26, facility staff were observed to be attentive to residents’ needs and treating residents with dignity and respect. Based on facility tours, interviews and observation, the department found that there is no evidence that facility staff do not treat residents with respect or speak inappropriately to residents; therefore, these allegations are found to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Exit interview conducted. Report left with facility.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2