445202879-4-13-2026-26-AS-CKAI-DTFTG9-20260424144242

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 445202879
Report Date: 04/13/2026
Date Signed: 04/13/2026 12:30:11 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/18/2026 and conducted by Evaluator Marcella Tarin

COMPLAINT CONTROL NUMBER: 26-AS-20260318100030

FACILITY NAME:	RACHELLE'S HOME III		FACILITY NUMBER:	445202879
ADMINISTRATOR:	ILAGAN, MYLA		FACILITY TYPE:	740
ADDRESS:	4101 FAIRWAY DRIVE		TELEPHONE:	(831) 201-4785
CITY:	SOQUEL	STATE: CA	ZIP CODE:	95073
CAPACITY:	26	CENSUS: 11	DATE:	04/13/2026
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Administrator (ADM) Myla Ilagan		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Staff physically abused resident by forcing resident to shower

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marcella Tarin conducted an unannounced complaint visit to deliver the findings of the above allegation. LPA met with Administrator (ADM) Myla Ilagan. LPA stated the purpose of the visit.

On 3/18/2026 the Department received a complaint with the above allegation.

On 3/19/2026 the Department interviewed the Reporting Party (RP). RP states a resident, referred to as R1, was ‘accosted’ by two staff members on 3/5/2026 by Staff S1 and Staff S2. RP states R1 was going to his/her room to change due to having a ‘bladder problem.’ RP states S1 and S2 grabbed R1 and ‘dragged’ R1 into the shower.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026

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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Control Number 26-AS-20260318100030

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: RACHELLE'S HOME III	FACILITY NUMBER: 445202879
	VISIT DATE: 04/13/2026

NARRATIVE

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On 3/25/2026 the Department conducted a complaint visit and interviewed the Licensee Rachelle Recinto, 3 Staff (S1 to S3) and 1 Resident (R1). Licensee stated there was an incident on 3/5/2026 with R1, when R1 was observed to be soiled in the dining area. Licensee stated R1 was offered help with a shower, to which R1 agreed to let staff help him/her with a shower. Licensee stated R1 walked with S1 and S2 to the shower. Licensee stated she then heard screaming and went to check on R1. Licensee stated she stood at the bathroom shower doorway and saw that R1 was being showered.

Licensee stated S2 told her that R1 did not want to shower anymore. Licensee stated she could not leave R1 in the shower, due to safety concerns of the floor being wet and R1 is a fall risk. Licensee stated S1 and S2 helped R1 out of the shower and S1 and S2 were told to leave R1 alone. Licensee stated that she and the facility staff “try so hard to help” R1 with bathing, toileting and dressing as part of R1’s care plan. Licensee stated R1 does not allow staff to help him/her with bathing, toileting and dressing. Licensee stated staff are scared of R1 because R1 will scream, yell, and make offensive statements to staff. Licensee stated R1 walks around the facility with soiled briefs/clothing and refuses to change. Licensee stated this is an ongoing hygiene concern and R1’s care team is aware of R1’s hygiene and refusal of care since 2025.

On 3/25/2026 the Department interviewed 3 Staff (S1 to S3). 3 Out of 3 staff state he/she is not aware of any incident where staff physically abused a resident by forcing the resident to shower. S1 stated on 3/5/2026 he/she was asked by the Licensee to help R1 to shower because R1 was soiled. S1 stated R1 agreed to let staff him/her. S1 stated S2 also helped R1 during this incident. S2 stated he/she was asked by Licensee to help R1 with a shower. S2 stated R1 agreed to let staff help him/her with a shower. S2 stated S1 helped bathe R1. S2 stated R1 then said he/she did not want to shower anymore. S2 stated R1 let S1 help him/her to get out of the shower and to put his/her clothes on.

On 3/25/2026 the Department interviewed Resident R1. R1 stated on 3/5/2026, he/she was dragged into the shower by two staff, S1 and S2. R1 stated he/she did not agree to staff helping him/her with a shower. R1 stated he/she did not ask for staff to help him/her. R1 stated he/she does not need help with bathing/showering.

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SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026

LIC9099 (FAS) - (06/04)

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Control Number 26-AS-20260318100030

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: RACHELLE'S HOME III	FACILITY NUMBER: 445202879
	VISIT DATE: 04/13/2026

NARRATIVE

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On 4/1/2026 the Department interviewed Witness 1 (W1). W1 stated he/she is aware of R1’s refusal of care by facility staff since 2025. W1 stated R1’s hygiene is an ongoing concern. W1 stated R1 is known to have behaviors of saying staff force him/her to bathe/shower when R1 is soiled. W1 stated R1 refuses medical and psychiatric care, calling doctors and psychiatrists ‘liars.’ W1 stated R1 is not receptive to care due to R1 having mental health impairments.

Review of R1’s physician’s report dated 1/27/2026, R1 diagnoses are mild cognitive impairment, with development of major neurocognitive impairment. R1’s physical health status is listed as having bladder incontinence, difficulty with balance and requiring assistance with repositioning and transferring. R1’s capacity for self care is listed as able to bathe, dress/groom, and care for own toileting needs. Review of R1’s Needs and Services plan dated 2/16/2026, R1’s mental status notes R1 refusal to shower, aggressive toward staff, with staff offering to help with personal hygiene. R1’s Physical Health, R1 refuses showers and help with changing, staff are to offer help daily to shower and remind to change briefs/diapers.

Review of Santa Cruz County Sheriff’s Office Daily Press Log from 3/1/2026 to 3/15/2026 notes an incident on 3/5/2026 at approximately 3:00PM. Review of the sheriff’s report noted R1 was interviewed and it was determined that no crime had been committed, and no injuries were observed. No additional follow up was conducted by the sheriff’s department.

Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies were cited during today’s visit, per California Code of Regulations, Title 22. An exit interview was conducted with Administrator (ADM) Myla Ilagan and a copy of this report was provided.

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END OF REPORT

SUPERVISORS NAME: Christine Kabariti
LICENSING EVALUATOR NAME: Marcella Tarin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026

LIC9099 (FAS) - (06/04)

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