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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345003008
Report Date: 09/30/2025
Date Signed: 09/30/2025 01:51:36 PM

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
08/14/2025 and conducted by Evaluator Lavinia Muscan
COMPLAINT CONTROL NUMBER: 59-AS-20250814132953
FACILITY NAME:LOVING ANGELS CAREHOME 2FACILITY NUMBER:
345003008
ADMINISTRATOR:MUNGCAL, MIRASOLFACILITY TYPE:
740
ADDRESS:4722 HACKBERRY LANETELEPHONE:
(916) 350-4749
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 5DATE:
09/30/2025
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Administrator Mirasol MungcalTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Resident sustained skin issue due to lack of care from staff
INVESTIGATION FINDINGS:
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On September 30, 2025, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator Mirasol Mungcal .

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

**Report continued on 9099-C**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
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 2
Control Number 59-AS-20250814132953
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: LOVING ANGELS CAREHOME 2
FACILITY NUMBER: 345003008
VISIT DATE: 09/30/2025
NARRATIVE
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Resident sustained skin issue due to lack of care from staff
The department reviewed records, interviewed witnesses, staff, administrator and residents to investigate this allegation. Four staff and administrator interviews reflected that they were aware of resident, R1 health care needs who have been residing at the facility since 12/04/24. Staff interviews indicated that R1 was alert and orientated. R1s home health staff interviews indicated that R1 was getting appropriate care at the facility and there were no reportable concerns. Record review reflected that the facility was documenting all care notes per R1s care plan and R1 was receiving care from home health once a week and from other agencies and there were no issues to address. It was also noted that R1 had skin issues on different parts of their body prior to admission and all parties were aware about addressing those skin issues. Based on the information gathered, it has been concluded that even R1 was having skin issues which were noted during their hospital visit on 08/12/25, it was not due to lack of care from staff, therefore this allegation was found to be UNSUBSTANTIATED.

Exit interview conducted. Report left with facility.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2