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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700186
Report Date: 08/11/2026
Date Signed: 08/11/2026 02:51:46 PM

Unfounded


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
08/05/2026 and conducted by Evaluator Kevin Mknelly
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20260805085612
FACILITY NAME:WALNUT HOUSEFACILITY NUMBER:
342700186
ADMINISTRATOR:PAZ, DIANAFACILITY TYPE:
740
ADDRESS:3401 WALNUT AVETELEPHONE:
(916) 483-6612
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:110CENSUS: 68DATE:
08/11/2026
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Diana PazTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not allowing resident to return to the facility
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/11/26 , Licensing Program Analyst (LPA) Kevin Mknelly arrived and met with Administrator to deliver investigation findings.
The department conducted record review and interviewed staff regarding complaint allegations. Staff interviewed stated that resident, R1 were living at the facility from April 2026 . R1 sent to hospital on 8/3/26 due to change in health conditions and having suicidal ideations. Facility was working with hospital staff for R1’s return to the facility and requesting all required paperwork including clearance for psychiatric evaluation to ensure the safety of R1. Record review indicated that facility received all required documents which included recent medical assessment (LIC602) , clearance for psychiatric evaluation from hospital around 8/6/26 and R1 returned to the facility on 8/6/26.
LPA interviewed R1.
Based on the information gathered, this allegation was UNFOUNDED. A finding that the allegations are Unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis.Exit interview conducted. A copy of this report has been provided to Administrator.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2026
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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