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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701167
Report Date: 07/18/2024
Date Signed: 07/18/2024 11:57:24 AM

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
05/16/2024 and conducted by Evaluator Tung Truong
COMPLAINT CONTROL NUMBER: 27-AS-20240516103544
FACILITY NAME:YOUNG AT HEART RCFE NO.1, INC.FACILITY NUMBER:
342701167
ADMINISTRATOR:MOLINYAWE, GLENDAFACILITY TYPE:
740
ADDRESS:9027 COLOMBARD WAYTELEPHONE:
(916) 689-7378
CITY:SACRAMENTOSTATE: CAZIP CODE:
95829
CAPACITY:6CENSUS: 6DATE:
07/18/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Glenda MolinyaweTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff speak inappropriately towards a resident
Staff do not allow a resident to file a complaint
Staff threatened a resident with eviction
INVESTIGATION FINDINGS:
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On 7/18/24, Licensing Program Analyst (LPA) Tung Truong arrived unannounced to complete and deliver the findings for a complaint received on 5/16/24. LPA met with Administrator Glenda Molinyawe and explained the purpose of the visit.

Throughout the course of the investigation, LPA conducted interviews and reviewed records. Based on records review, and staff and resident interviews, there is insufficient evidence to substantiate the allegations mentioned above. Based on resident interviews, 4 out of 6 residents stated staff did not speak inappropriately to residents. Residents reported that their personal rights were not being violated and that they have no concerns with care. Based on staff interviews, staff denied the allegations mentioned above, stating that they did not speak to resident (R1) inappropriately.

Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Tung Truong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024
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 2
Control Number 27-AS-20240516103544
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: YOUNG AT HEART RCFE NO.1, INC.
FACILITY NUMBER: 342701167
VISIT DATE: 07/18/2024
NARRATIVE
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Staff stated R1 was allowed to file complaints as R1 has a personal cell phone. Staff also stated that R1 was never being threatened with eviction. Moreover, the investigation revealed that R1 is diagnosed of dementia with behavioral disturbance and schizoaffective behavior. R1 corroborated that the allegations above were false and that staff is good to R1.

As a result of the investigation, LPA finds the allegation above 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 the evidence to prove that the alleged violation occurred.

Exit interview was conducted and a copy of the report was provided upon exit.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Tung Truong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2