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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701192
Report Date: 01/21/2026
Date Signed: 01/21/2026 10:53:16 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
01/15/2026 and conducted by Evaluator Shakaricka Hughes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260115155807
FACILITY NAME:VITA BELLA ELDERLY CARE IIIFACILITY NUMBER:
342701192
ADMINISTRATOR:SERA NAKALEVUFACILITY TYPE:
740
ADDRESS:6700 SUN RIVER DRTELEPHONE:
(916) 490-0237
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY:14CENSUS: 13DATE:
01/21/2026
UNANNOUNCEDTIME BEGAN:
08:44 AM
MET WITH:Facility Staff: Sera NakalevuTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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9
Facility is in disrepair.
INVESTIGATION FINDINGS:
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13
On 01/21/2026 at 9:00 AM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with the facility administrator Sera Nakalevu and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the above allegation. The current census is 13.

Allegation: Facility is in disrepair.
It was alleged that the facility is in disrepair. This investigation consisted of interview with facility staff, residents, and facility observations. On 1/21/2026 LPA Hughes conducted a visit to the facility. LPA spoke with facility staff (S1) who stated that a concern was raised regarding an electrical outlet being in disrepair, S1 stated that the electrical outlet in resident (R1) room was repaired professionally within 3 days of being made aware of the issue. Additional interview with 4 out of 4 residents in care reported no concerns about the facility or their rooms being in disrepair. Interview with resident (R1) indicated no concerns about the facility or their room being in disrepair.
Continuation 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
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-20260115155807
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: VITA BELLA ELDERLY CARE III
FACILITY NUMBER: 342701192
VISIT DATE: 01/21/2026
NARRATIVE
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 Resident (R1) stated that facility staff promptly addressed their concerns regarding an electrical outlet being in disrepair, stating that the outlet was repaired within 3 days after raising the concern to facility staff. LPA observed resident (R1) bedroom and noticed the electrical outlet to be in good repair at this time, without any cords attached to the outlet. There is not enough evidence to corroborate this allegation, therefore this allegation is unsubstantiated.

The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegation is found to be UNSUBSTANTIATED. A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2