342700018-8-20-2026-27-AS-SRIN-DXL24M-20260903170410

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700018
Report Date: 08/20/2026
Date Signed: 08/20/2026 02:46:38 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
10/09/2025 and conducted by Evaluator Arvin Villanueva

COMPLAINT CONTROL NUMBER: 27-AS-20251009100804

FACILITY NAME:	GROVE HOME CARE		FACILITY NUMBER:	342700018
ADMINISTRATOR:	BOBOC, LUCIA		FACILITY TYPE:	740
ADDRESS:	8410 TERRACOTTA CIRCLE		TELEPHONE:	(916) 225-6405
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95624
CAPACITY:	6	CENSUS: 6	DATE:	08/20/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Lucia Boboc		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff yelling in presence of residents.

INVESTIGATION FINDINGS:

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On August 20, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrvied at this facility unannounced to conduct a follow-up complaint investigation and deliver findings regarding the allegations noted above. LPA initially met with staff on duty, Jellian Sinclair (S1) and stated the purpose of the visit. The adminsitrator, Lucia Boboc (AD), was notified and arrived shortly after.
Allegation – Staff Yelling in the Presence of Residents
The investigation into this allegation consisted of interviews, record reviews and observation.
Interviews with other residents and their responsible parties denied witnessing the staff yelling in their presence. Staff members also denied seeing staff yell in front of residents in care. Administrator denied yelling at staff in front of residents.
During an interview on September 3, 2025, R1 stated that staff always try to help R1 and have never treated R1 roughly or spoken to R1 inappropriately. R1 said staff are careful when speaking with R1 and that R1 had never heard harsh or inappropriate words. During interviews with residents on September 16, 2025, no residents reported that staff were rude, harassing, or inappropriate.
Records from unannounced facility visits conducted on August 14, 2025, September 3 and 16, 2025, October 15 and 31, 2025, November 4, 2025, January 7, February 27, March 11, August 12, and August 20, 2026, did not document staff or the administrator yelling at residents, staff, or in the presence of residents.
Based on the available evidence, there were no interviews, observations, or records showing that staff yelled in the presence of residents. Therefore, the allegation is unfounded.
Exit interview was conducted and a copy of this report was provided.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
10/09/2025 and conducted by Evaluator Arvin Villanueva

COMPLAINT CONTROL NUMBER: 27-AS-20251009100804

FACILITY NAME:	GROVE HOME CARE		FACILITY NUMBER:	342700018
ADMINISTRATOR:	BOBOC, LUCIA		FACILITY TYPE:	740
ADDRESS:	8410 TERRACOTTA CIRCLE		TELEPHONE:	(916) 225-6405
CITY:	SACRAMENTO	STATE:CA	ZIP CODE:	95624
CAPACITY:	6	CENSUS: 6	DATE:	08/20/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Lucia Boboc		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff retaliating against resident.
Staff not assisting resident with medication.
Staff mishandling resident’s medication.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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 5

Control Number 27-AS-20251009100804

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GROVE HOME CARE	FACILITY NUMBER: 342700018
	VISIT DATE: 08/20/2026

NARRATIVE

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Allegation – Staff retaliating against resident
The investigation into this allegation consisted of interviews and record reviews.
Records showed that R1’s care needs had increased over time. R1’s 2023 records showed that R1 already needed help with bathing, dressing, toileting, transfers, repositioning, and wheelchair use due to weakness from a prior stroke. The August 5, 2025, and September 4, 2025, assessments showed further decline. R1 was weak and unstable, could no longer turn independently in bed, and required two caregivers for transfers and personal care. R1 was also having difficulty supporting themselves and could no longer safely perform some tasks independently.
The facility issued a 30-day eviction notice, dated 9/5/2025, based on its assessment that R1's care needs were beyond the level of care the facility could safely provide. The records also documented ongoing concerns regarding communication and cooperation with R1’s Power of Attorney (POA), including missing medical forms, limited communication with health care providers, and disagreements about R1’s care. Staff also documented incidents involving conflict between the POA and facility staff.
Records dated October 4, 2025, stated that R1 had refused to get out of bed, shower, and eat dinner. Staff reported that this had been happening for about three months. Staff also documented that R1 was weak, could not turn in bed, slept much of the day, and could no longer give themselves eye drops. The note stated that R1’s care needs had increased and were beyond the level of care the facility could provide. The POA was notified of R1’s condition
A September 7, 2025, note stated that police were called because of concerns about R1’s POA’S verbal aggression, blocking the facility entrance, refusal to follow facility safety rules, and concerns about resident privacy. The facility also documented concerns that R1’s POA’s behavior was causing distress to staff and other residents. These records describe conflict between the facility and the POA; however, they do not show that staff retaliated against R1.
On October 20, 2025, staff told POA that an updated Medical Assessment (LIC602A form) was needed so the facility could properly document R1’s condition and provide the correct care. The facility reported that the form was not received.
Other residents, and their responsible parties that were interviewed and denied witnessing retaliation from staff. Staff members stated that they had not seen staff retaliate against R1 at the facility.
The records reviewed did not show that staff retaliated against R1. Instead, the records support that the facility was documenting R1’s decline and concerns about facility’s ability to safely meet R1’s increased care needs. Based on the interviews and records reviewed, the allegation of staff retaliation against R1 is unsubstantiated.
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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 27-AS-20251009100804

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GROVE HOME CARE	FACILITY NUMBER: 342700018
	VISIT DATE: 08/20/2026

NARRATIVE

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Allegation – Staff Not Assisting Resident With Medication
The investigation into this allegation consisted of interviews and record reviews.
Other residents and their responsible parties that were interviewed reported no medication concerns. Staff member (S1) denied the allegation and stated that staff help and guide R1 with taking their medications, including eye drops, glucose testing, and inhalers. Interview with R1 which also stated that S1 helps R1 with glucose testing.
During the August 14, 2025, interview, S1 explained that R1 performs own finger prick while staff provide guidance and supervision. S1 demonstrated this process to LPA Somer Hayes and stated R1 understood that staff are not allowed to perform the finger prick for residents. Administrator Lucia Boboc stated that staff stay with R1 during medication times, prepare and administer medications, and supervise or guide R1 when R1 is unable to independently perform tasks such as glucose testing and eye drops. Lucia stated that R1’s ability to self-administer these tasks started to significantly decline beginning around May 2025.
On September 3, 2025, LPA Hayes and Lucia reviewed R1’s medication records and compared R1’s medications with current and previous medication lists. Discontinued medications were identified and separated for return to the POA. LPA Hayes instructed the facility to follow only current physician orders and not administer medications without a valid prescription. No medication discrepancies were found during the review.
Additional records show that R1’s physical condition declined during 2025. R1’s care records documented weakness, difficulty with mobility, and increased need for assistance with daily activities. On October 4, 2025, staff documented that R1 was unable to administer own eye drops and that R1’s care needs had increased. On October 20, 2025, staff documented concerns that the POA had provided medications that the facility could not administer without proper medical documentation.
The November 9, 2025, confidential report also documented concerns involving the POA’s communication with the facility and medical providers, including delays in medical care and failure to provide updated medical information. These records show ongoing concerns regarding care coordination but do not establish that facility staff failed to assist R1 with medications.
Based on the available evidence, staff provided medication assistance, supervision, and guidance based on R1’s abilities and current physician orders. No medication discrepancies were identified during the LPA’s review. Therefore, the allegation that staff did not assist R1 with medication administration is unsubstantiated.

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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 27-AS-20251009100804

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: GROVE HOME CARE	FACILITY NUMBER: 342700018
	VISIT DATE: 08/20/2026

NARRATIVE

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Allegation – Staff Are Mishandling Resident’s Medication

The investigation into this allegation consisted of interviews and record reviews.

Staff member (S1) denied the allegation and stated that staff assist and guide R1 with medication administration, including eye drops and glucose testing. Interview with R1 also stated that S1 helps R1 with glucose testing.

Administrator Lucia Boboc stated that she prepares R1’s medications and staff administer them. She reported that staff supervise R1 with tasks R1 can perform independently and document medication refusals. Lucia also stated that some medications were brought by the POA without physician orders, and staff could not administer them without proper documentation.

On September 3, 2025, LPA Hayes and Lucia reviewed R1’s medication records, medication lists, and destruction log. Discontinued medications were separated for return to the POA. LPA Hayes instructed the facility to follow the current medication list and only administer medications with valid physician orders. No medication discrepancies were found during the review.

Records showed R1’s ability to manage some medications and treatments declined over time, and staff provided supervision and guidance as needed. Although there were disagreements between the facility and POA regarding medications and medical instructions, there was insufficient evidence that staff incorrectly administered, withheld, or otherwise mishandled R1’s medications. Therefore, based on the available evidence, the allegation is unsubstantiated.

A finding that the complaint allegation 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.

No deficiencies were cited. Report was reviewed with AD during exit interview. A copy of this report was provided.
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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

LIC9099 (FAS) - (06/04)

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