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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315920211
Report Date: 10/23/2025
Date Signed: 10/23/2025 03:40:08 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
10/06/2025 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20251006093136
FACILITY NAME:MILLPORT VILLASFACILITY NUMBER:
315920211
ADMINISTRATOR:AREFA, NEGASHFACILITY TYPE:
740
ADDRESS:7641 MILLPORT DRIVETELEPHONE:
(916) 472-6669
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:6CENSUS: 5DATE:
10/23/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Schvonda Peters- RobertsonTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not have planned activities for a resident
Staff are mistreating a resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
 On 10/23/25, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with designee.
LPA conducted records review and extensive interviews.
LPA is unable to find and or meet the preponderance, per policy.
Records found that R1 is not diagnosed with cognitive disability. R1 is dependent on others for physical assist from bed by a 2-person hoyer lift.
Interviews and records showed that facility staff have tried to plan with R1 to insure 2 staff are available for care and activities. Staff report R1 regularly refuses activies when staff are available at agreed upon times. R1 states that assisance is not offered as claimed by staff.
R1 statements of mistreatment by staff are in conflict with staff reports of R's behavior.
As a result of this investigation, LPA finds allegation to be (US)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 the evidence to prove that the alleged violation occurred.
Exit interview with designee.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Kevin Mknelly
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
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
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
10/06/2025 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20251006093136

FACILITY NAME:MILLPORT VILLASFACILITY NUMBER:
315920211
ADMINISTRATOR:AREFA, NEGASHFACILITY TYPE:
740
ADDRESS:7641 MILLPORT DRIVETELEPHONE:
(916) 472-6669
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:6CENSUS: 5DATE:
10/23/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Schvonda peters- RobertsonTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff neglect resulted in a resident sustaining multiple pressure injuries.
Staff are not meeting a resident's bathing needs.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
 On 10/23/25 , Licensing Program Analyst (LPA) Kevin Mknelly LPA Mknelly arrived and met with designee to deliver investigation findings.
LPA reviewed staff records, facility records, and conducted interviews.
LPA finds that facility met Tittle 22 requirements.
There are no medical records of R1 sustaining a pressure injury. R1 stated and showed LPA some skin conditions on his left and right legs. LPA encouraged R1 to seek medical evaluation of their skin. To date R1 has refused in person medical care.
Facility records show R1 is scheduled and offered baths when 2 staff are available. When R1 does not participate in scheduled baths, R1 receives bed baths from staff.
This agency has investigated the above complaint allegations. We have found that the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.
Exit interview conducted and report provided.
Unfounded
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Kevin Mknelly
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2