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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315003016
Report Date: 05/05/2026
Date Signed: 05/05/2026 03:48:33 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
04/24/2026 and conducted by Evaluator Melissa Parks
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20260424101341
FACILITY NAME:SENIOR CARE VILLA OF LOOMISFACILITY NUMBER:
315003016
ADMINISTRATOR:SHREETIKA CHANDFACILITY TYPE:
740
ADDRESS:3400 CHISOM TRAILTELEPHONE:
(916) 652-8000
CITY:LOOMISSTATE: CAZIP CODE:
95650
CAPACITY:35CENSUS: 21DATE:
05/05/2026
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Heidi CharetteTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff did not follow infection control practices
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Melissa Parks arrived on Tuesday May 5, 2026 unannounced to conclude a complaint which was received by the Department on 4/24/2026. LPA met with acting Executive Director Heidi and explained the purpose of the visit.

LPA interviewed the acting Administrator, staff, and home health regarding the allegation. LPA learned the following: North Star Senior Living, the management company for this facility, has an infection control policy and procedure for staff to follow. Per staff, this was not being followed. Specifically, staff did not immediately contact primary physicians regarding scabies exposure, bagging and sealing clothes for 14 days, and cleaning/disinfecting furniture.

Based on the information detailed above, LPA finds the allegation to be substantiated. A finding that the allegation is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Deficiency cited on 9099-D.
Exit interview. Copy of report and appeal rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Melissa Parks
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026
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 59-AS-20260424101341
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: SENIOR CARE VILLA OF LOOMIS
FACILITY NUMBER: 315003016
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/05/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/19/2026
Section Cited
CCR
87470(a)(2)
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87470 Infection Control Requirements (a) A licensee shall ensure that infection control practices are maintained as follows:(2) Environmental cleaning and disinfection activities shall be performed . . .This requirement was not met as evidenced by staff interviews. This poses a direct threat
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Facility to submit a plan regarding the facility following infection control plan.
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to the health and safety of residents in care.
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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: Laura Munoz
LICENSING EVALUATOR NAME: Melissa Parks
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026
LIC9099 (FAS) - (06/04)
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