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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315920122
Report Date: 12/23/2025
Date Signed: 12/23/2025 12:11:16 PM

Unsubstantiated


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
11/21/2025 and conducted by Evaluator Melissa Parks
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20251121132658
FACILITY NAME:ANGELS SUNRISE VILLA INC.FACILITY NUMBER:
315920122
ADMINISTRATOR:KUMAR, ALPESHFACILITY TYPE:
740
ADDRESS:2060 DONOVAN DRIVETELEPHONE:
(916) 847-0842
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY:6CENSUS: 6DATE:
12/23/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Alpesh KumarTIME COMPLETED:
12:40 PM
ALLEGATION(S):
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Facility staff fail to manage residents’ incontinence
Facility staff fail to provide nutritious meals at reasonable mealtimes
Staff not provided sleeping accommodations
Resident bedding not maintained as clean and in good condition
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Melissa Parks arrived on Tuesday December 23, 2025, to conclude a complaint investigation regarding the above allegations. LPA met with Administrator Alpesh and explained the purpose of the visit.

Throughout the course of the investigation, LPA interviewed the Administrator and staff. LPA toured the facility and inspected resident beds. LPA learned the following: meal times are as following: breakfast at 6am, lunch at 12pm, and dinner between 5pm and 6pm. Per staff, if a resident does not want to eat a meal at the described time, it will be saved and offered to them at a later time. LPA inspected the fridge and pantry and saw a variety of perishable and nonperishable foods, including fruit, meat, and vegetables. Per the Administrator and staff, there is awake staff on the NOC shift. There is no bed or staff quarters provided. All staff interviewed stated that NOC shift staff are awake. LPA interviewed staff who stated that residents are changed every 2 hours and/or as needed. LPA observed all resident beds to have appropriate bedding. Bedding appeared clean and did not have an odor. There was additional bedding stored at the facility to be used, if needed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Melissa Parks
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
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-20251121132658
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: ANGELS SUNRISE VILLA INC.
FACILITY NUMBER: 315920122
VISIT DATE: 12/23/2025
NARRATIVE
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Based on information obtained during the investigation, LPA finds the allegations to be UNSUBSTANTIATED- a finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

Exit interview. A copy of this report was provided to the Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Melissa Parks
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2