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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315920340
Report Date: 04/22/2026
Date Signed: 04/22/2026 03:02:44 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
03/13/2026 and conducted by Evaluator Bethany Mirlohi
COMPLAINT CONTROL NUMBER: 59-AS-20260313112615
FACILITY NAME:RAI ANGELS 2FACILITY NUMBER:
315920340
ADMINISTRATOR:RAI, BALWINDERFACILITY TYPE:
740
ADDRESS:1422 ORWELL DRTELEPHONE:
(916) 945-2122
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:6CENSUS: 6DATE:
04/22/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Balwinder Rai, AdministratorTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Staff speak inappropriately to residents
Staff do not provide adequate food service
Staff do not ensure that facility is free of insects
Resident fell and sustained injury due to lack of supervision
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to complete investigation into allegations listed above. LPA met with Balwinder Rai during today’s inspection.

LPA investigated allegation, “Staff speak inappropriately to residents”. LPA interviewed staff, relevant party, clients, and reviewed documentation. LPA interviewed relevant party in which they stated staff members yelled at R1, called them names, and were rude. LPA interviewed R1 who stated staff members were rude once to them but could not remember further details. LPA interviewed 1 resident in the facility in which they stated care staff have never been rude to them and treat them kindly. LPA interviewed administrator in which she stated she never observed staff members being rude or speaking inappropriately to R1 or other residents. Care staff present during the time of the incident no longer work at the home. Due to the information gathered, LPA finds allegation to be unsubstantiated.
Continuation on 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
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-20260313112615
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: RAI ANGELS 2
FACILITY NUMBER: 315920340
VISIT DATE: 04/22/2026
NARRATIVE
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LPA investigated allegation, “Staff do not provide adequate food service”. LPA interviewed staff, relevant party, clients, reviewed documentation and toured kitchen area. LPA interviewed relevant party in which they stated residents are only being served frozen vegetables, no snacks, and no desserts. LPA interviewed R1 in which they stated they did not like the food but was unable to give further details. LPA interviewed a resident in care, and they stated they sometimes liked the food, and sometimes did not, however there is always enough food provided. LPA toured the kitchen and found 2-day perishable and 7-day non-perishable amount of food. LPA observed fresh fruits and vegetables available and canned goods. LPA reviewed facility menus and observed meals had proteins, fruits and vegetables available. Due to the information gathered, LPA finds allegation to be unsubstantiated.

LPA investigated allegation “Staff do not ensure that facility is free of insects”. LPA interviewed staff, relevant party, clients, and toured the facility. Relevant party reported that R1 was seeing cockroaches in their room. Relevant party never saw them personally however R1 sent relevant party a picture of a cockroach that they found. LPA interviewed R1 in which they stated they observed cockroaches in the bathroom and their bedroom. LPA interviewed a current resident in which they stated they have never observed bugs within the home. LPA interviewed caregivers in which they stated they have not observed bugs within the home. LPA interviewed administrator in which she stated her husband sprays around the house monthly and they have never had a bug problem. LPA toured the facility and did not observe any bugs within the facility. Due to the information gathered, LPA finds allegation unsubstantiated.

LPA investigated allegation, “Resident fell and sustained injury due to lack of supervision”. LPA interviewed staff, relevant party, clients, and reviewed documentation. Relevant party reported that R1 fell due to staff neglect and lack of supervision. Relevant party reported that staff did not check on R1 throughout the night, even though R1 was a fall risk. LPA interviewed R1 in which they stated they fell in the middle of the night and was on the ground for an hour or so before staff found them. R1 was unable to provide LPA with further details. LPA reviewed R1’s needs and service plan in which it stated at times R1 wakes up at night and wanders in their room and caregiver is to make sure the resident is safe and encourage them to go back to sleep.

Continuation on 9099-C.

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20260313112615
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: RAI ANGELS 2
FACILITY NUMBER: 315920340
VISIT DATE: 04/22/2026
NARRATIVE
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Staff notes indicated R1 had a fall around 6 am, complained about pain and so R1 was sent out to the hospital around 6:20 am. Staff notes indicated that R1 had 1 previous fall, and no injuries were reported. 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: 04/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3