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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700018
Report Date: 11/04/2025
Date Signed: 03/17/2026 09:51:58 AM

Substantiated


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
08/08/2025 and conducted by Evaluator Sommer Hayes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250808162409
FACILITY NAME:GROVE HOME CAREFACILITY NUMBER:
342700018
ADMINISTRATOR:BOBOC, LUCIAFACILITY TYPE:
740
ADDRESS:8410 TERRACOTTA CIRCLETELEPHONE:
(916) 225-6405
CITY:SACRAMENTOSTATE: CAZIP CODE:
95624
CAPACITY:6CENSUS: 5DATE:
11/04/2025
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Lucia BobocTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Unlawful Eviction
INVESTIGATION FINDINGS:
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 This is an amended report to ensure the document is correctly classified as a public document. Licensing Program Analyst (LPA) Sommer Hayes arrived and met with Lucia Boboc to deliver investigation findings regarding complaint control number 27-AS-20250808162409, Unlawful eviction.
LPA reviewed resident records including the admission agreement and 30-day eviction notice dated 08/05/25. LPA finds that the allegations cited above are substantiated.

LPA Hayes observed that the eviction notice (08/06/25) does not meet regulatory requirements, as it failed to include the approved eviction criteria outlined in Title 22 regulations. The notice cited R1’s pre-existing health conditions prior to admission as the reason for eviction, which does not comply with the specified regulatory standards.
(Continued on 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
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 5
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
08/08/2025 and conducted by Evaluator Sommer Hayes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250808162409

FACILITY NAME:GROVE HOME CAREFACILITY NUMBER:
342700018
ADMINISTRATOR:BOBOC, LUCIAFACILITY TYPE:
740
ADDRESS:8410 TERRACOTTA CIRCLETELEPHONE:
(916) 225-6405
CITY:SACRAMENTOSTATE: CAZIP CODE:
95624
CAPACITY:5CENSUS: DATE:
11/04/2025
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Lucia BobocTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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9
Staff performs blood glucose testing on residents in care.
INVESTIGATION FINDINGS:
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This is an amended report to ensure the document is correctly classified as a public document. Licensing Program Analyst (LPA) Sommer Hayes arrived and met with Lucia Boboc to deliver investigation findings regarding complaint control number 27-AS-20250808162409, Staff performs blood glucose testing on residents in care.

The Administrator/Licensee stated that R1 is the only resident in the facility who receives finger pricks and had a physician’s order for glucose monitoring at the time of this complaint. According to the Administrator/Licensee the facility staff do not administer glucose finger pricks to any other residents in the facility. LPA Hayes interviewed two of five residents. R2 expressed no concerns regarding their medical needs and reported no knowledge of staff administering finger pricks to residents. R1 was interviewed and stated that staff “used to” check their glucose levels but are now “teaching” R1 to check their own levels.
Continued on 9099-C
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
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 5
Control Number 27-AS-20250808162409
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: GROVE HOME CARE
FACILITY NUMBER: 342700018
VISIT DATE: 11/04/2025
NARRATIVE
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LPA Hayes also interviewed the POA (P2) of R1, who stated they had not observed any staff performing finger pricks on R1 or any other resident. In addition, the POA of R3 reported that they had not witnessed any staff administering finger pricks in the facility. Staff member (S)1 was interviewed and stated that they only assist R1 with checking their glucose levels but do not perform the finger pricks themselves. Administrator/Licensee stated that effective 08/28/25 R1's doctor note states that R1 finger pricking has been discontinued.

Based on interviews and record review, the above allegation is UNSUBSTANTIATED. Based on interviews and record reviews during the investigation, LPA Hayes was unable to corroborate the allegations.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Sommer Hayes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 27-AS-20250808162409
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: GROVE HOME CARE
FACILITY NUMBER: 342700018
VISIT DATE: 11/04/2025
NARRATIVE
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Upon record review of the resident (R1)’s file, it was determined that this resident, upon admission to this facility, had the pre-existing conditions stated in the original eviction notice dated 08/06/25 from Licensee, Lucia Boboc to R1 and R1’s POA. Making the eviction dated 08/06/25 an unlawful eviction.

87224 Eviction Procedures
87224 (a) (4) If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463, and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident.

Lucia Boboc provided LPA Hayes with the first eviction notice (dated 08/06/25) on 08/06/25. This eviction notice was served to the R1 and their POA before The Department reviewed the eviction notice. A revision to the eviction notice was requested by LPA Hayes during a virtual meeting on 09/05/25 with Lucia Boboc. LPA Hayes assisted Lucia Boboc with the revision of the eviction letter which was later approved by LPA Hayes and reissued to R1 and R1’s POA.

Based on interviews and record review, the above allegations are SUBSTANTIATED. A finding that the complaint allegations are substantiated means that the allegations are valid because the preponderance of evidence standard has been met. This facility is hereby cited per Title 22 CCR Sections 87224 (a)(4). An exit interview was held with Lucia Boboc. A copy of this report and appeal rights were left with Lucia Boboc.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Sommer Hayes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20250808162409
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: GROVE HOME CARE
FACILITY NUMBER: 342700018
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/11/2025
Section Cited
CCR
87224(a)(4)
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87224 Eviction Procedures
87224 (a) (4) If, after admission, it is determined that the resident has a need not previously identified and...
This requirement was not met as evidenced by:
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Licensee has updated the eviction notice dated 08/06/25 to reflect a lawful eviction. The eviction notice dated 09/05/25 has been approved by the Department.
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Based on record review and interviews, review of the eviction notice issued by the Licensee poses a potential health, safety, and/or personal rights risk.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Sommer Hayes
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5