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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700458
Report Date: 09/24/2025
Date Signed: 09/24/2025 02:27:02 PM

Unsubstantiated


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
09/03/2025 and conducted by Evaluator Kevin Gould
COMPLAINT CONTROL NUMBER: 27-AS-20250903154616
FACILITY NAME:MUIRFIELD A HOME FOR THE ELDERLYFACILITY NUMBER:
342700458
ADMINISTRATOR:CARPIO, ORLANDO JR.FACILITY TYPE:
740
ADDRESS:7541 MUIRFIELD WAYTELEPHONE:
(916) 424-4553
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:6CENSUS: 5DATE:
09/24/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Marilyn CarpioTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff engaged in inappropriate interactions with residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Kevin Gould made an unannounced inspection to the Muirefield A Home For the Elderly RCFE on 9/24/25 at 1:00pm to conclude the investigation of the above allegation and to deliver the findings. LPA Gould met with staff, Marilyn Carpio and together discussed the investigation details.

Based on the interviews conducted during the investigation process and statements obtained during the investigation process, LPA Gould was unable to corroborate the allegations. LPA Gould conducted several collateral inspections at current and previous placements for R1. No staff member has observed an individual visiting R1 or observed R1 in a romantic relationship with a caregiver from the facility at their current or former placement. Staff members interviewed denied the allegations. LPA conducted interview with R1's authorized representative and no other corroborating information was obtained.

Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2025
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 27-AS-20250903154616
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: MUIRFIELD A HOME FOR THE ELDERLY
FACILITY NUMBER: 342700458
VISIT DATE: 09/24/2025
NARRATIVE
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LPA conducted a collateral interview with R1 who does believe a relationship existed but was unable to provide any corroborating evidence and some information provided such as visitations was denied by staff at R1's current placement and former skilled nursing facility.

Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of personal rights are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed.

There are no deficiencies is cited per California Code of Regulations, TITLE 22.

Exit interview was conducted with facility staff. Appeal Rights were issued, and a copy of this report was left at the facility.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2