342701167-7-2-2025-27-AS-KHOS-DJKJRW-20250714071725

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701167
Report Date: 07/02/2025
Date Signed: 07/02/2025 05:35:41 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
03/12/2025 and conducted by Evaluator Cynthia Tamayo

COMPLAINT CONTROL NUMBER: 27-AS-20250312152218

FACILITY NAME:	YOUNG AT HEART RCFE NO.1, INC.		FACILITY NUMBER:	342701167
ADMINISTRATOR:	MOLINYAWE, GLENDA		FACILITY TYPE:	740
ADDRESS:	9027 COLOMBARD WAY		TELEPHONE:	(916) 689-7378
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95829
CAPACITY:	6	CENSUS: 6	DATE:	07/02/2025
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Glenda Molinyawe		TIME COMPLETED:	05:57 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not meet a resident's incontinence needs
Staff speak inappropriately towards a client
Staff threatened a resident with eviction
Staff are mishandling a resident's personal funds
Staff does not provide daily activities for resident
Staff do not assist resident with obtaining medical appointments

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 07/02/25, Licensing Program Analyst (LPA) Cynthia Tamayo conducted an unannounced facility visit to close a complaint investigation. LPA Tamayo met with administrator Glenda Molinyawe and explained the purpose of today's visit. The census is 6.

During today’s visit, LPA Tamayo toured the facility with administrator Glenda Molinyawe and observed 5 residents in the facility. LPA Tamayo interviewed three residents (R1-R3). LPA reviewed The following documents pertaining to residents 1-6 (R1-R6):
-- Current Resident Roster
- LIC 601 Identification and Emergency
- LIC 602 Physician’s Report
-Posted Activity calendar (June)
-Financial record keeping for R1
Continued LIC 9099

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Cynthia Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025

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 3

Control Number 27-AS-20250312152218

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: 07/02/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

- Current LIC 500 Personnel Report
-LIC 624 Incident reports
-LIC 625 Needs and Service Plan
-Incontinence Log
-Progress or Case notes

LPA Tamayo interviewed three residents who were able to respond verbally and coherently (R1, R2, and R3). R4-R5 were asleep during this visit and R4 was hospitalized/not present at the facility during this visit. Of these, two were not diagnosed with any sort of cognitive impairments (R1 and R2). R3 voiced no concerns with their quality of care, and said they receive all assistance when needed. R1 voiced no concerns with quality of care, and said that other residents are cared for appropriately by staff, such as ensuring that they are bathed and that their diapers are changed regularly. R1 stated they were off their medications when they made a complaint. R2 voiced no concerns with their quality of care and said they had their basic needs met and they receive assistance with other ADLs when requested.

R1 stated staff is "very nice here" and helps them with Medical appointments, speak appropriately with residents. R2 stated staff has not treated eviction stating "I was just of my medications and yelling a lot". R1 stated they do activities such as reading the bible and playing disco. Staff is assisting R1 with rescheduling an eye appointment due to Doctor ending the video call during the last appointment as a result of inappropriate comments made by R1. R1 stated he is lonely and wants to talk to someone and wants a counselor. R1 has their next medical appointment scheduled for 7/15/2025 at 2:00PM with their primary care physician. Staff stated they socialize with R1 but will look into a counselor request and additional resources. R1 stated they know S1's phone number by memory and call them everyday to talk to them.

The department has determined the following as it relates to the allegations that staff do not ensure residents' incontinence needs are met, speaking inappropriately towards a client, staff threatening a resident with eviction, mishandling a resident's personal funds, staff does not provide daily activities for resident, and
assisting residents with obtaining medical appointments.

Continued on 9099-C

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Cynthia Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 27-AS-20250312152218

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: 07/02/2025

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	Based on interviews and observations, the above allegations are UNSUBSTANTIATED, which means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. No deficiencies were cited regarding the above allegations. An exit interview was held and a copy of this report was left at the facility .

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Cynthia Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 3