092700445-8-26-2025-59-AS-LMUZ-DKXQJL-20250827121254

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 092700445
Report Date: 08/26/2025
Date Signed: 08/26/2025 11:49:07 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
05/29/2025 and conducted by Evaluator Lavinia Muscan

COMPLAINT CONTROL NUMBER: 59-AS-20250529102107

FACILITY NAME:	PAVILION AT EL DORADO HILLS, THE		FACILITY NUMBER:	092700445
ADMINISTRATOR:	WALL, ALISON M		FACILITY TYPE:	740
ADDRESS:	2288 FRANCISCO DR		TELEPHONE:	(916) 542-3452
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	64	CENSUS: 52	DATE:	08/26/2025
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Administrator Michael Owens		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff do not keep the facility free of ants

INVESTIGATION FINDINGS:

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On 8/26/2025, Licensing Program Analyst (LPA) Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator Michael Owens. During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation. The results of the investigation are as follows:
Based on documents obtained and statements reviewed, the department determined that there was insufficient evidence that the facility is not kept free of ants. The facility representative stated that the pest control company comes in monthly, and more often as needed. Department reviewed Pest Control data for the past 6 months on 01/13/25, 02/05/25, 03/05/25, 04/08/25, 05/12/25, and 06/10/25. The pest control company is continuing to monitor any pest/insect activity. During 06/06/2025, 07/15/2025 and 07/24/25 visits, the facility was toured, and no activity of ants was observed by the department. Therefore, the above allegation is UNSUBSTANTIATED. A finding that the complaint 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 conducted. Report left with facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2025

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

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
05/29/2025 and conducted by Evaluator Lavinia Muscan

COMPLAINT CONTROL NUMBER: 59-AS-20250529102107

FACILITY NAME:	PAVILION AT EL DORADO HILLS, THE		FACILITY NUMBER:	092700445
ADMINISTRATOR:	WALL, ALISON M		FACILITY TYPE:	740
ADDRESS:	2288 FRANCISCO DR		TELEPHONE:	(916) 542-3452
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	64	CENSUS: 52	DATE:	08/26/2025
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Administrator Michael Owens		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff do not ensure that resident needs are met in a timely manner
Staff does not treat residents with dignity or respect
Staff speak inappropriately in the presence of residents

INVESTIGATION FINDINGS:

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Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 59-AS-20250529102107

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: PAVILION AT EL DORADO HILLS, THE	FACILITY NUMBER: 092700445
	VISIT DATE: 08/26/2025

NARRATIVE

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Staff do not ensure that resident needs are met in a timely manner – UNFOUNDED
During the investigation the department interviewed residents and staff and completed file reviews. Four (4) resident interviews stated that staff meet resident care needs and respond in a timely manner. The department interviewed six (6) caregivers on duty in which they stated residents do not have to wait for long periods of time for care, and staff respond to residents’ needs in a quick manner. Due to the information gathered, the Department finds the allegation to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Staff does not treat residents with dignity or respect - Unfounded
Staff speak inappropriately in the presence of residents

The department interviewed eight (8) staff and four (4) residents during a complaint investigation. The department conducted a tour of the facility on 06/05/25, 07/15/25 and 07/24/25 and conducted interviews with residents and staff. Interviews indicated that all staff treat all residents with dignity and respect and do not speak inappropriately to residents. During a facility tour on 06/05/25, 07/15/25 and 07/24/24, facility staff were observed to be attentive to residents’ needs and treating residents with dignity and respect. During residents’ interviews, residents did not express any concern in this area. Based on facility tours, interviews and observation, the department found that there is no evidence that facility staff do not treat residents with respect, or speak inappropriately to residents; therefore, these allegations are found to be UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Exit interview conducted. Report left with facility.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2025

LIC9099 (FAS) - (06/04)

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