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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347001947
Report Date: 04/02/2026
Date Signed: 04/02/2026 06:26:42 PM

Substantiated


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
03/30/2026 and conducted by Evaluator Sabrina Calzada
COMPLAINT CONTROL NUMBER: 59-AS-20260330170806
FACILITY NAME:EVA'S CARE HOMEFACILITY NUMBER:
347001947
ADMINISTRATOR:NEMETHY, EVAFACILITY TYPE:
740
ADDRESS:8220 CATALPA DRIVETELEPHONE:
(916) 727-1904
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 4DATE:
04/02/2026
UNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Eva Nemethy, Administrator TIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Unlawful eviction.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to commence a complaint investigation and with met with Robert Kovacs, caregiver, and explained purpose of inspection. Administrator, Eva Nemethy, arrived at 2:30 pm. LPA observed (3) residents in their rooms at the start of the inspection. There are no residents under hospice. LPA observed (1) resident return from health care provder/recreation and was advised (1) resident (R2) is still hospitliazed from March 28, 2026.

LPA interviewed the Administrator, (1) staff, and a case manager from a health care provider. LPA reviewed documentation relating to resident (R1), including the Physician's Report, Admission Agreement, incident report, and appraisal/care plan. The results of the investigation are as follows:

(R1) moved to the facility on February 14, 2026 post surgery to the abdominal midline and with an ileostomy that home health was caring for and Stage 4 Kidney failure. (R1) did not have any neurocognitive impairments.
*cont on 9099C-1..
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2026
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 3
Control Number 59-AS-20260330170806
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: EVA'S CARE HOME
FACILITY NUMBER: 347001947
VISIT DATE: 04/02/2026
NARRATIVE
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9099C-1,Allegation: Unlawful Eviction: The allegation states that resident (R1) was reportedly told they have (3) day notice to vacate while was hospitalized.

LPA spoke with a representative from a health care provider that stated the facility was "refusing to take (R1) back" for the reason that they "can't manage the ileostomy". The representative stated the facility administrator stated she would provide a 3-day notice to (R1), and then refused to take them back from the hospital. (R1) was placed at another board and care.

Both the Administrator and staff stated that (R1) began declining each week shortly after moving in due to their diagnoses, including cancer and (R1) refusing to get chemotherapy treatment, dialysis, a hospice evaluation and going to the Emergency Room for (3) days. An incident report was submitted to the department along with a signed refusal from (R1), dated March 21, 2026.

The Administrator stated that the hospital contacted her after (R1) had been in the hospital for (4-5) days and asked if (R1) could return to the facility. The administrator stated she was not comfortable taking (R1) back with the ileostomy because there were issues the nurses were aware of, a large wound near the ileostomy site, which was present when (R1) moved in but became stabilized after a few weeks due to the nurses oversight. Additionally, the skilled nursing stated to the facility that (R1) would be having another type of surgery (2) weeks after moving in and an ileostomy would not be needed after that, but the surgery did not happen due to (R1) not obtaining a physician. (R1) was sent out to the Emergency Room on March 22, 2026 due to finally agreeing to go after having no urine output for three days.

The admission agreement states that (30) day written notice will be issued as a condition for eviction, and a (3) days may be given with provided there is written approval from the Department. The administrator confirmed that a written eviction notice was not issued to (R1) and (R1) return to the care home.

Based on information obtained, the allegation is found to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following (1) citation is issued on the 9099-D page. Exit interview. Copy of report and appeal rights emailed.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20260330170806
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: EVA'S CARE HOME
FACILITY NUMBER: 347001947
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/16/2026
Section Cited
CCR
1569.683(a)(1)
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ยง1569.683 Eviction notices; reasons for eviction contents; service. a) In addition to complying with other applicable regulations, a licensee of a residential care facility for the elderly who sends a notice of eviction to a resident shall set forth in the notice to quit the reasons relied upon for the eviction, with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. In addition, the notice to quit shall include all of the following: (1) The effective date of the eviction.This requirement is not met as evidenced by:
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Licensee/Administrator agrees to consider respite care, if appropriate, and to admit residents on a short-term basis.

Licensee/Administrator agrees to read Reg 87507/Admission Agreement and submit a statement of understanding. Due by April 16, 2026.
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Based on interviews conducted and documentation reviewed, the Licensee did not ensure a 30-day eviction notice was issued to (R1), who was refusing emergency services, including there being issues with ileostomy bag, which posed a potential health and safety risk to residents in care.
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LIcensee/Administrator agree to reach out to the Department LPA or Officer of the Day with questions.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3