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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345002859
Report Date: 11/06/2025
Date Signed: 11/06/2025 10:47:43 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
10/21/2025 and conducted by Evaluator Michael Hood
COMPLAINT CONTROL NUMBER: 59-AS-20251021153337
FACILITY NAME:MOAIFACILITY NUMBER:
345002859
ADMINISTRATOR:FOWLER, CRAIG M.FACILITY TYPE:
740
ADDRESS:2633 CARDINAL COURTTELEPHONE:
(916) 844-5250
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:5CENSUS: 0DATE:
11/06/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Craig M. Fowler, AdministratorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Facility staff physically abused resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Craig Fowler, to deliver findings into the complaint allegation listed above.

During the investigation, LPA conducted interviews, toured the facility, and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

Allegation: Facility staff physically abused resident in care.

** Report continued on 9099-C **
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Anthony Perez
NAME OF LICENSING PROGRAM ANALYST: Michael Hood
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
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 59-AS-20251021153337
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: MOAI
FACILITY NUMBER: 345002859
VISIT DATE: 11/06/2025
NARRATIVE
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Interview with resident (R1) indicated that they moved into the facility on May 5, 2024 and are a family member of Administrator. R1 stated that they were physically assaulted by Administrator and staff member (S1). R1 could not recall time and date in which Administrator assaulted them, however, R1 stated that there was a witness (W1) who observed Administrator physically abuse R1. R1 stated that W1 will deny allegation to protect Administrator. R1 stated that S1 assaulted them on September 20, 2025 in their bedroom. R1 stated that there were no witnesses who observed S1 assault them. They contacted local law enforcement, but they felt that law enforcement didn't do anything.

Interviews with Administrator and S1 indicated that they have never witnessed anyone physically abuse R1 or any other resident. Administrator and S1 both denied ever being physically abusive to R1 or any other resident. Administrator indicated that they have never been in a physical altercation with R1 and indicated that they ensured there was a witness when conversing with R1. Interview with W1 indicated that they have never witnessed physical abuse at the facility involving anyone. W1 denied witnessing Administrator physically assault R1 at the facility. W1 stated that they have spent a fair amount of time at the care home and they have never witnessed physical abuse. LPA contacted local law enforcement for records and information regarding 9-1-1 calls made from the care home on September 20, 2025, September 21, 2025, and September 22, 2025. LPA spoke with local law enforcement representative via telephone call, who stated that no police report was completed regarding incidents. Local law enforcement representative stated that there was a "disturbance" at the facility on September 20, 2025, September 21, 2025, and September 22, 2025, but no crime was found to be committed. Local law enforcement representative stated that there were no physical abuse claims made for any of the 9-1-1 calls mentioned above. Local law enforcement representative stated that there were claims of staff withholding medications from resident, staff yelling at resident, and staff pushing wheelchair of resident to face wall. Local law enforcement representative stated that all parties were advised of their options. Local law enforcement representative stated there were claims of mental abuse but not physical. LPA received Event Details documents from law enforcement which corroborated statements made by local law enforcement representative.

** Report continued on 9099-C **
NAME OF LICENSING PROGRAM MANAGER: Anthony Perez
NAME OF LICENSING PROGRAM ANALYST: Michael Hood
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20251021153337
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: MOAI
FACILITY NUMBER: 345002859
VISIT DATE: 11/06/2025
NARRATIVE
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Based on interviews conducted and records reviewed, the preponderance of evidence standards have not been met. Therefore, the above allegation is found to be UNSUBSTANTIATED. A finding that a complaint allegation 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 with Licensee. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.
NAME OF LICENSING PROGRAM MANAGER: Anthony Perez
NAME OF LICENSING PROGRAM ANALYST: Michael Hood
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3