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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315001689
Report Date: 08/27/2026
Date Signed: 08/27/2026 12:12:01 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/07/2026 and conducted by Evaluator Bethany Mirlohi
COMPLAINT CONTROL NUMBER: 59-AS-20260707141111
FACILITY NAME:TAJ RESIDENTIAL CARE IIFACILITY NUMBER:
315001689
ADMINISTRATOR:AMREEN K BISLAFACILITY TYPE:
740
ADDRESS:8289 HORNCASTLE AVENUETELEPHONE:
(916) 772-1547
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:6CENSUS: 6DATE:
08/27/2026
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Gurdip Judge, AdministratorTIME COMPLETED:
12:25 PM
ALLEGATION(S):
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Staff did not dispense medications as prescribed
Staff yelled at resident
Staff sprayed resident in the face with water
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to deliver complaint findings. LPA met with Gurdip Judge during today’s inspection.
LPA investigated allegation, “Staff did not dispense medications as prescribed”. LPA interviewed R1 and they stated that staff were consistently giving R1 the wrong medication or not giving medication at all. LPA interviewed R1’s responsible party in which they stated there were a few incidents in which the staff were not giving R1 the correct medications. Responsible party was unable to recall specific details. LPA interviewed licensee and administrator in which they stated they always provided the appropriate medications and gave R1 their prescribed medications daily. Licensee and administrator stated there were several incidents in which R1 spit out medications or would refuse the medications being given. Licensee stated they informed responsible party and the doctor and R1 had several medication changes and doctor appointments due to R1’s refusal of medications and behaviors.
Continuation on 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
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 2
Control Number 59-AS-20260707141111
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
FACILITY NAME: TAJ RESIDENTIAL CARE II
FACILITY NUMBER: 315001689
VISIT DATE: 08/27/2026
NARRATIVE
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R1 moved out of the facility on 5/7/26 and no medications was available for LPA to review. LPA reviewed documentation of several incidents in which it states R1 refused her medications or spit them out. LPA interviewed 1 additional resident in care and they stated they receive all medications as prescribed. Due to the information gathered LPA finds allegation to be unsubstantiated.

LPA investigated allegation, “Staff yelled at resident.” LPA interviewed R1 and they stated care staff yelled in their face. LPA interviewed care staff, licensee, and administrator and they stated no one has yelled at a resident in care. Licensee stated no family, residents, or other visitors have ever reported that staff are yelling at residents. LPA interviewed responsible party in which they stated R1 reported to them that staff yelled at them. LPA interviewed another resident in care and they stated the staff are kind and have not yelled at them or others residents in care. Due to the information gathered LPA finds allegation to be Unsubstantiated.

LPA investigated allegation, “Staff sprayed resident in the face with water”. LPA interviewed R1 in which they stated staff sprayed them in the face with water during a shower. LPA interviewed responsible party, and they stated R1 reported to them that staff sprayed them in the face with water during a shower. LPA interviewed care staff, administrator, and licensee and they state no one sprayed R1 in the face with water during a shower. LPA interviewed a different resident in care and they stated staff are kind and treat them respectfully during care. Due to the information gathered, LPA finds allegation to be unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are unsubstantiated.



Exit interview was conducted and copy of report provided.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2