<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701084
Report Date: 05/01/2024
Date Signed: 05/02/2024 12:17:16 PM

Unfounded


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
04/22/2024 and conducted by Evaluator Victoria Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20240422144541
FACILITY NAME:R & E SENIOR CARE, INC.FACILITY NUMBER:
342701084
ADMINISTRATOR:EMILY PASCUAFACILITY TYPE:
740
ADDRESS:5231 OLIVEHURST WAYTELEPHONE:
(916) 895-4357
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:6CENSUS: 4DATE:
05/01/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Emily PascuaTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff forced resident to drink medicine
Facility staff verbally abused residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
AMENDED LICENSEE AGREED
Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct an investigation of the above mentioned allegations on 5/1/24 at 8:30a. LPA met with Emily Pascua and stated the purpose of the visit. LPA toured the facility and interviewed resident #1 (R1) - (R4) and the Administrator and Caregiver Randy Pozon during this visit. LPA requested a list of staff with contact information, food receipts, facility utility bills, and resident roster. There is 1 resident on hospice during this visit. Based on interviews and review of paid utility bills and food receipts for January - April 2024. The allegations above are deemed Unfounded.

"The allegation is UNFOUNDED, meaning that the allegation was false, could not have happened and/or was without a reasonable basis. This Department has therefore dismissed the complaint."

Per California Code of Regulations, no deficiencies were observed or cited. Exit interview held, and a copy provided.
Unfounded
Estimated Days of Completion: 60
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Victoria Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024
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 1