345920176-1-22-2026-59-AS-TORZ-DQWSPB-20260202130249

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345920176
Report Date: 01/22/2026
Date Signed: 01/22/2026 02:59:38 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
12/18/2025 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 59-AS-20251218112025

FACILITY NAME:	GOLDEN AGE LIVING 1		FACILITY NUMBER:	345920176
ADMINISTRATOR:	SOUMAHORO, MUAMOUDOU A		FACILITY TYPE:	740
ADDRESS:	3375 LA CADENA WAY		TELEPHONE:	(916) 389-9683
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95835
CAPACITY:	6	CENSUS: 2	DATE:	01/22/2026
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Helen Scarlett and Judith Gayle		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

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Staff is not fingerprint cleared to provide care and supervision to residents.
Staff emotionally abuse residents.
Staff does not treating residents with respect.
Staff not keeping residents personal information confidential.

INVESTIGATION FINDINGS:

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Licensing Program Analyst Kerry Hiratsuka conducted this unannounced complaint visit to deliver the results of the allegation above.

LPA reviewed facility records and conducted interviews. Each side interviewed stated different version of events. LPA was able to interview three of four residents at the time and LPA was unable to determine the events. Complainant did not give any identifying information or examples of the incidents. LPA did confirm current staff do have criminal record clearance. LPA interviewed staff. LPA cannot determine the alleged incidents based on lack of information.

Based on interviews conducted by the Department and records review, the preponderance of evidence standards has 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.
Caregiver stated she was uncomfortable to sign report and declined to sign.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026

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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