342701514-8-13-2025-27-AS-SRIN-DKRNQ9-20250821103930

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701514
Report Date: 08/13/2025
Date Signed: 08/13/2025 02:13:25 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
04/23/2025 and conducted by Evaluator Vincent Moleski

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20250423080638

FACILITY NAME:	SUMERLIN GUEST HOME 2		FACILITY NUMBER:	342701514
ADMINISTRATOR:	CALDEIRA, MARIA SOCORRO		FACILITY TYPE:	740
ADDRESS:	8667 SUMERLIN CT.		TELEPHONE:	(916) 304-3575
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	6	CENSUS: 3	DATE:	08/13/2025
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Sarah Jane Egante		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff did not supervise resident resulting in AWOL

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to deliver findings on this complaint. LPA Moleski met with Sarah Jane Egante and explained the purpose of the visit.

This investigation consisted of interviews and record review.

LPA Moleski reviewed an incident report from this facility dated 4/18/25. According to the incident report, a resident (R1) became upset after being told to change their clothes on April 17, 2025. On that date, R1 walked out of the facility and spoke with a community member in the neighborhood, according to the incident report. Police were contacted, and R1 was taken to the hospital afterward, per the incident report.

LPA Moleski reviewed R1’s file. A narrative note dated April 17, 2025 indicated that R1 became agitated on that date and eloped from the facility. The note stated that a caregiver followed R1, and called law enforcement for assistance. [continued on 9099-C]

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20250423080638

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: SUMERLIN GUEST HOME 2	FACILITY NUMBER: 342701514
	VISIT DATE: 08/13/2025

NARRATIVE

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LPA Moleski reviewed R1’s LIC 602 and observed that they were not permitted to be in the community unsupervised.

In an interview, the facility’s house manager (S1) said that R1 left the facility, but was followed by a caregiver (S2) as R1 walked over to a nearby neighbor’s property. In an interview, S2 said that they followed R1 for the entire time they were away from the facility. S3 was also working at the facility on April 17, 2025. S3 said they observed R1 leave the facility through the front doors, with S2 following after them. S3 said they stayed inside in order to supervise the remaining residents.

LPA Moleski attempted to contact the neighbor visited by R1, but they did not respond to a request for an interview. LPA Moleski obtained a police report regarding this incident, dated April 17, 2025. In that police report, the neighbor’s initial statement to law enforcement was recorded. The neighbor told police that they witnessed R1 approach their home, followed by facility staff. However, R1 had refused to return to the facility with the staff, according to the report. R1 was eventually placed on a 5150 hold, per the report.

The department has determined the following as it relates to the allegation that staff did not supervise a resident, resulting in an elopement (AWOL):

Based on interviews and record review, the above allegations are UNSUBSTANTIATED, which means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that a violation occurred.

No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with
Egante.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

LIC9099 (FAS) - (06/04)

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