342700018-8-27-2026-27-AS-SRIN-DXLU42-20260904151425

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700018
Report Date: 08/27/2026
Date Signed: 08/27/2026 03:00:00 PM

Unsubstantiated

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
09/02/2025 and conducted by Evaluator Arvin Villanueva

COMPLAINT CONTROL NUMBER: 27-AS-20250902125416

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:	08/27/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Lucia Boboc		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Resident's change of condition was not brought to the attention of the resident's physician and the resident's responsible person
Staff handled resident in a rough manner
Staff spoke inappropriately to resident in care
Staff did not provide adequate accommodations to resident in care
Staff did not safeguard resident’s confidential records
Staff did not follow the doctor’s orders for resident in care
Staff did not safeguard resident’s personal belongings
Staff falsified resident records

INVESTIGATION FINDINGS:

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On August 27, 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrive at this facility unannounced to conduct a follow-up complaint investigation and deliver findings regarding the allegations noted above. LPA met with Administrator, Lucia Boboc, and stated the purpose of the visit.

Overview: The complaint involves resident (R1) and several concerns about R1’s care and treatment at this facility. The complainant (RP) alleges that staff did not provide proper care, including leaving R1 sitting in urine, handling R1 roughly, and speaking to R1 in a rude or disrespectful way. RP also reports that R1 developed a wound on the thigh area and that staff did not report to R1’s family or doctor. Other concerns include staff not following doctor’s orders, not providing proper accommodation, going through R1’s personal belongings, and not protecting R1’s private records. RP also alleges that staff threatened R1, and falsified or backdated records.
{1}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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 9

Control Number 27-AS-20250902125416

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: 08/27/2026

NARRATIVE

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Allegation - Resident's change of condition was not brought to the attention of the resident's physician and the resident's responsible person.

The investigation into this allegation consisted of interviews and focused mainly on resident (R1).

Interview was conducted with Administrator Lucia regarding R1’s change in condition and communication with R1’s physician and responsible person. Lucia stated that R1’s Power of Attorney (POA) did not allow Lucia or facility staff to speak with R1’s doctors, the hospital or other services involved in R1’s care. Lucia reported that she tried to speak with R1’s home health nurse, but the nurse stated that she did not want to be involved in the disagreement between the R1’s family and the facility. Lucia stated that, sometimes, she had contacted R1’s other POA, who she described as more pleasant to communicate with. Lucia also stated that the hospital contacted her when R1 needed to be discharged. Lucia told the hospital that R1 needed rehabilitation because the facility could not provide the level of care R1 needed. R1 was then discharged to a rehabilitation facility and did not return to the facility. Lucia stated that she wanted the home health nurse to connect her with a social worker so she could discuss R1’s change in condition. Lucia also stated that R1’s POA did not share information with the facility about R1’s doctor appointments most of the time, until the last minute. Lucia reported that she had requested updated Medical Assessment (LIC602 form) from the POA since 2024 and again in 2025, but the POA refused.

On January 16, 2026 interview, Lucia stated that she was in constant contact with R1’s responsible person regarding R1’s declines and other challenges. Lucia stated that the responsible person visited the facility every day, and they spoke often about R1.

On January 16, 2025, staff member S1 was interviewed. S1 stated that when a resident has a change in condition, Lucia is contacted right away. S1 stated that even when a resident has a cold, Lucia contacts the resident’s doctor for direction and contacts the responsible person for that resident. S1 stated that the family is informed right away and that staff communicate with the doctor when needed.
{2}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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: 9 of 9

Control Number 27-AS-20250902125416

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: 08/27/2026

NARRATIVE

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On January 16, 2026, R2’s responsible person was interviewed and stated that the administrator texts them immediately when something happens to their parent. R3’s responsible person was also interviewed on January 16, 2026, and did not report any concerns related to the allegation.

Based on the interviews, the evidence does not establish that the facility failed to notify the responsible person when there was a change in a resident’s condition. The interviews did not provide sufficient evidence, therefore, the allegation that resident's change of condition was not brought to the attention of the resident's physician and the resident's responsible person was unsubstantiated.

*********************************************************************************************

Allegation - Staff handled resident in a rough manner.

The investigation into this allegation consisted of interviews.

On January 16, 2026, R2’s responsible person was interviewed regarding the allegation. The responsible person stated that they had not seen staff handle R2 in a rough manner. The responsible person stated that they visit the facility three times a day and also visit on weekends. They stated that they are at the facility often and have not seen anything bad happen there.

On January 16, 2026, R3’s responsible person was interviewed. The responsible person denied seeing staff handle residents in a rough manner. They stated that the facility is always very pleasant.

On September 3, 2025, R2 was interviewed and did not report any concerns about staff handling them in a rough manner during care. On the same date, R1 was interviewed and stated that staff had never handled R1 in a rough manner. R1 stated that staff always tried to help R1 and had never harmed R1.

On September 3, 2025, staff member S1 was interviewed. S1 stated that she had never seen staff handle residents roughly or speak to residents in a harsh manner. S1 also stated that she had never handled residents in this way and had not seen other staff do so.
{3}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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 9

Control Number 27-AS-20250902125416

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: 08/27/2026

NARRATIVE

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On September 16, 2025, LPA Moleski interviewed residents receiving care at the facility, including R1. None of the residents reported that staff harassed residents or were rude or inappropriate toward them.

Administrator Lucia was interviewed and denied the allegation that staff handled a resident in a rough manner. Lucia, along with S1, corroborated that R1 sometimes did not want to be touched, especially in the genital area. Staff stated that R1 would cry even when the nurse came to provide care. Staff also stated that R1 would cry during physical therapy (PT), and the PT would sometimes stop and leave the session because R1 was crying. Lucia stated that R1 cried when someone touched certain parts of R1’s body that she did not want touched.

Based on the interviews, no residents, responsible persons, or staff reported witnessing staff handling residents in a rough manner. R1 specifically stated that staff had never handled R1 roughly or harmed R1. The available evidence does not support the allegation that staff handled a resident in a rough manner, therefore the allegation was unsubstantiated.

**********************************************************************************************

Allegation – Staff spoke inappropriately to resident in care.
The investigation into this allegation consisted of interviews, record reviews and observations.

On January 16, 2026, R2’s responsible person stated they had not observed staff speaking inappropriately to R2. R3’s responsible person also denied seeing inappropriate behavior and stated that staff are always nice.

On September 3, 2025, R1 stated that staff were cautious when speaking to R1 and did not use harsh words or speak to R1 inappropriately. R1 also stated that staff always tried to help R1 and had never harmed R1.

A review of prior unannounced facility visits conducted between August 14, 2025, and August 20, 2026, found no observations or notes of staff or the administrator yelling at or speaking inappropriately to residents or staff.
{4}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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: 3 of 9

Control Number 27-AS-20250902125416

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: 08/27/2026

NARRATIVE

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On September 16, 2025, LPA Moleski interviewed residents in care, including R1. No residents reported that staff harassed them or were rude or inappropriate.

Based on the interviews, observations, and review of facility visit records, there was insufficient evidence to support that staff spoke inappropriately to a resident in care, therefore the allegation was unsubstantiated.

*********************************************************************************************

Allegation – Staff did not provide adequate accommodations to resident in care.

The investigation into this allegation consisted of interviews. The main focus of this investigation is not providing R1 with an alternative accommodation when the bedside table that R1 was using was taken away.

On August 27, 2026, Administrator Lucia stated that the bedside table removed from R1’s room belonged to a hospice agency and had been loaned to a previous resident. The hospice agency later took the table back. Lucia stated that R1’s responsible person brought another table for R1 to use. Lucia also stated that if R1 needed a table, she would have provided another one. She clarified that the original table did not belong to the facility.

On January 16, 2026, two family members of other residents were interviewed and they did not report concerns regarding the accommodations provided to their parents. Staff S1 stated that residents are well cared for and that staff change residents as needed, usually three to four times a day. S1 also stated that staff change bed mats and pads and clean or change bedding when needed.

On September 3, 2025, in an interview with R2, R2 did not report any concerns regarding the accommodations provided.

Based on the interviews, there was insufficient evidence to support that staff did not provide adequate accommodations to a resident in care, therefore, this allegation was unsubstantiated.

{5}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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: 4 of 9

Control Number 27-AS-20250902125416

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: 08/27/2026

NARRATIVE

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Allegation – Staff did not safeguard resident’s confidential records.

The investigation into this allegation consisted of interviews and observations.

On August 27, 2026, Administrator Lucia stated that resident records are kept locked in cabinets and a closet. She also stated that R1 had a locked mailbox for her mail. On January 16, 2026, R2’s responsible person stated that resident records are kept under lock and key. R3’s responsible person also stated that resident documents were secured.

On September 3, 2025, interview with R1 which R1 stated that R1 was not aware of their personal information being exposed. R1 also stated that R1 could not remember a document that was left for R1 in their bedroom to sign and was unsure if R1 had signed it.

Staff S1 stated that resident charts and documents are confidential and are always kept locked. S1 stated that documents are kept in folders and are only removed when needed for CCLD or the fire department. Lucia also stated that R1’s documents are kept in a locked closet and facility have a mailbox that is locked.

During facility visits on August 12 and August 27, 2026, LPA observed resident files, medications, and other confidential documents stored in locked cabinets and a locked closet.

Based on interviews and facility observations, there was insufficient evidence to support the allegation that resident confidential records were not safeguarded, therefore, the allegation was unsubstantiated.

{6}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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: 5 of 9

Control Number 27-AS-20250902125416

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: 08/27/2026

NARRATIVE

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Allegation – Staff did not follow the doctor’s orders for resident in care.

The investigation into this allegation consisted of interviews and medication review.

Interview was conducted with Administrator Lucia regarding R1’s change in condition and communication with R1’s physician and responsible person. Lucia stated that R1’s Power of Attorney (POA) did not allow Lucia or facility staff to speak with R1’s doctors, the hospital or other services involved in R1’s care.
On January 16, 2026, R2’s responsible person stated that staff communicate well and let them know when there are concerns. R3’s responsible person also stated that they were pleased with the administrator and staff. Lucia also stated that R1’s POA did not share information with the facility about R1’s doctor appointments most of the time, until the last minute. Lucia reported that she had requested updated Medical Assessment (LIC602 form) from the POA since 2024 and again in 2025, but the POA refused.

On September 3, 2025 interview, Lucia stated that R1’s responsible person brought a large bag of medication to the facility. Lucia did not accept the medications because they needed to be properly logged and stored. Lucia asked R1’s responsible person to refill a specific medication and left the empty bottle on the counter. When R1’s responsible person later brought pills and filled the bottle themselves, Lucia rejected the medication.

On September 3, 2025, LPA Sommer Hayes and Lucia reviewed R1’s medications and Medication Administration Records. The medications were compared with the most current medication list, and discontinued medications were separated. LPA Hayes instructed the licensee to follow only the current prescription list and not give medications without a valid prescription. No medication discrepancies were observed during the review.

Based on the interviews and medication review, there was insufficient evidence to support the allegation that staff did not follow the doctor’s orders for R1, therefore, the allegation was unsubstantiated.

{7}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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: 6 of 9

Control Number 27-AS-20250902125416

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: 08/27/2026

NARRATIVE

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Allegation – Staff did not safeguard resident’s personal belongings.

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

A review of the Resident Personal Property and Valuables (LIC 621) for all six residents showed that the facility documented large and valuable items brought by residents upon admission and throughout their stay at this care facility. Some residents did not want to inventory their clothing, so clothing was not always listed.

On August 27, 2026, staff S1 stated that resident belongings are safeguarded by labeling items with the resident’s name. S1 stated that R1’s belongings were kept in their private bedroom and were labeled. Administrator Lucia stated that the facility labels belongings with the resident’s name or room number. Lucia also stated that R1 had their own bedroom and a locked mailbox.

On January 16, 2026, R2 and R3’s responsible persons denied seeing any concerns with the handling of their parents’ belongings. They described the residents’ belongings as neat, clean, and orderly. Lucia and S1 also stated that resident belongings and personal care items are kept safe, with some items stored in locked areas.

On September 3, 2025, R1 was interviewed and did not report any of their belongings going missing, misplaced or mismanaged.

Based on the record review and interviews, there was insufficient evidence to support that staff did not safeguard a resident’s personal belongings, therefore, the allegation was unsubstantiated.

{8}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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: 7 of 9

Control Number 27-AS-20250902125416

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: 08/27/2026

NARRATIVE

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Allegation – Staff falsified resident records

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

In an interview, Administrator Lucia stated that R1’s responsible person (POA-1) had altered R1’s doctor visit summaries. Lucia stated that information was removed by cutting pages, using white-out, or crossing out information with markers. Lucia stated that some of the removed information may have been important to R1’s care.

On January 16, 2026 interviews, R2’s responsible person stated that staff have been forthcoming and that R2 would tell him if anything happened. R3’s responsible person stated that resident documents are secured. Staff S1 stated that she did not know anything about records being falsified and stated that staff do not alter resident records. Lucia also denied falsifying documents.

A review of documents that were collected throughout to this investigation did not provide sufficient evidence that resident records were falsified by facility staff.

Based on the interviews and document review, there was insufficient evidence to support the allegation that staff falsified resident records, therefore, the allegation was unsubstantiated.

Note: 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 Lucia during the exit interview. A copy of this report and appeal rights were provided.

{9}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
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: 8 of 9