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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700827
Report Date: 07/22/2026
Date Signed: 07/22/2026 05:47:23 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
02/11/2026 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20260211123649
FACILITY NAME:ABOUNDING PEACE ELDERLY CAREFACILITY NUMBER:
342700827
ADMINISTRATOR:WAQALALA, UNAISIFACILITY TYPE:
740
ADDRESS:7124 HAYWARD DRTELEPHONE:
(916) 578-8834
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY:6CENSUS: 6DATE:
07/22/2026
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Deaja MalcolmTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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The facility allowed excluded individuals to work in the facility.
Staff are forging resident documents.
INVESTIGATION FINDINGS:
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On July 22 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct a follow-up investigation visit regarding the allegations noted above. LPA met with staff on duty, Deaja Malcolm (S3) and stated the purpose of the visit. LPA telephoned the administrator Unaisa Waqalala but she did not answer. LPA followed up with an email. Later she telephoned back at 4:45pm and arrived approximately 5:12pm.
Present upon arrival were 6 residents with 1 staff on duty (S3).

Allegation - The facility allowed excluded individuals to work in the facility:
The investigation into this allegation consisted of interviews, observations, and record reviews.
On February 19, 2026, LPA Villanueva interviewed 6 of 6 residents. When photos of the excluded individuals (E1 and E2) shown, 5 of 6 residents did not recognize or remember seeing them at the facility.
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Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
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 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
02/11/2026 and conducted by Evaluator Arvin Villanueva
COMPLAINT CONTROL NUMBER: 27-AS-20260211123649

FACILITY NAME:ABOUNDING PEACE ELDERLY CAREFACILITY NUMBER:
342700827
ADMINISTRATOR:WAQALALA, UNAISIFACILITY TYPE:
740
ADDRESS:7124 HAYWARD DRTELEPHONE:
(916) 578-8834
CITY:SACRAMENTOSTATE:CAZIP CODE:
95828
CAPACITY:6CENSUS: 6DATE:
07/22/2026
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Unaisi WaqalalaTIME COMPLETED:
06:00 PM
ALLEGATION(S):
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The Administrator is not present at the facility for a sufficient amount of time
INVESTIGATION FINDINGS:
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On July 22 2026, Licensing Program Analyst, Arvin Villanueva (LPA), arrived unannounced at this facility to conduct a follow-up investigation visit regarding the allegations noted above. LPA initially met with staff on duty, Deaja Malcolm and stated the purpose of the visit. The Administrator, Unaisi Waqalala was notified and arrived at 5:20pm.
Present upon arrival were 6 residents with 1 staff on duty.

Allegation - The Administrator is not present at the facility for a sufficient amount of time:
The investigation into this allegation consisted of observations, record reviews and interviews.
A review of this LPA's visits to the facility on February 19, 2026, February 27, 2026, March 20, 2026, and July 17, 2026, showed that the administrator was not present during any of those visits. A review of the facility's LIC 500 Personnel Report, dated June 5, 2026, showed that the administrator was scheduled to work at the facility on Mondays, Tuesdays, and Wednesdays from 10:00 a.m. to 2:00 p.m. and on Saturdays and Sundays from 12:00 p.m. to 4:00 p.m.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 27-AS-20260211123649
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: ABOUNDING PEACE ELDERLY CARE
FACILITY NUMBER: 342700827
VISIT DATE: 07/22/2026
NARRATIVE
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One of the residents stated they saw E1 about one year ago but could not remember the exact date. This resident explained that they saw E1 outside the facility picking up a trailer. During the visit, the LPA observed a trailer in the facility driveway. LPA also interviewed staff. One staff member stated they know E1 and E2 but had not seen them at this facility.
This staff reported seeing E2 at another facility around April 2025 but could not remember the exact date. Other staff members confirming knowing E1 and E2 but stated they have not seen them at this facility since employment but seen them at other facilities a long time ago but could not estimate when.
A review of the facility's LIC 500 Personnel Report showed that neither E1 nor E2 was listed as facility staff. In addition, during the LPA's visits on February 19, February 27, March 20, and July 17, 2026, neither E1 nor E2 was observed at the facility, and there were no reports confirming their presence. Based on the evidence gathered, there is not enough information to support the allegation that the facility allowed excluded individuals to work at the facility. Therefore, this allegation was unsubstantiated.
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Allegation - Staff are forging resident documents:

The investigation into this allegation consisted of interviews and record verification. On July 17, 2026, LPA contacted the physicians' offices where each resident received their Medical Assessment (LIC 602A) to verify that the residents had been seen by the listed physicians. Five of the six residents were confirmed by the medical offices. For one resident, the information could not be fully verified because the clinic had a different last name and address on file, although the birth date matched. Therefore, the verification for that resident was inconclusive. Interviews with staff could not confirm whether staff, the administrator or anyone working at this facility, had forged resident documents.

Based on the evidence gathered, there is not enough information to support the allegation that staff forging resident documents. Therefore, this allegation is unsubstantiated.

A finding that the complaint allegations are UNSUBSTANTIATED means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.


Exit interview was conducted with Unaisi Waqalala and a copy of this report and appeal rights were provided.
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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 27-AS-20260211123649
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: ABOUNDING PEACE ELDERLY CARE
FACILITY NUMBER: 342700827
VISIT DATE: 07/22/2026
NARRATIVE
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In one staff interview, the last time this staff seen the administrator at the facility was approximately one to two weeks earlier, around June 30, 2026. They stated the administrator comes to the facility about every two weeks and usually stays for up to two hours to complete a walkthrough, review paperwork, and perform other administrative duties. Another staff member stated that they report to another staff named Yelena Bigelow rather than to the administrator. According to this staff member, they have not seen the administrator since this staff only works part-time at this facility.

Interviews with residents in care, some residents stated they did not know who the administrator was nor did they recognized the name Una (Administrator).

Based on the administrator's documented work schedule, the administrator's absence during multiple LPA visits, statements from staff regarding the administrator's limited presence, and residents' inability to identify or confirm the presence of the administrator at the facility, the evidence supports the allegation that the administrator was not present at the facility for a sufficient amount of time. Therefore, the allegation is substantiated.

A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met.



Deficiencies cited on the LIC 9099-D, per Title 22 Regulations. Failure to correct will result in civil penalties.

Plan of correction and appeals were discussed during the exit interview with Unaisi; and a copy of this report and appeal rights were provided to facility.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20260211123649
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: ABOUNDING PEACE ELDERLY CARE
FACILITY NUMBER: 342700827
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2026
Section Cited
CCR
87405(a)
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The administrator…shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified in this section.
This requirement is not met as evidenced by:
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Per discussion, the administrator will start documenting their presence at the facility including the date, arrival time, departure time, and duties completed during each visit; will title it Administrator Visit Log.
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Based on interviews, record reviews and observations, the administrator were not present during multiple LPA visits, the conflicting staff statements about how often the administrator is at the facility, and residents being unable to identify or recall seeing the administrator. This poses a potential health, safety, or personal rights risks to residents in care.
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Administrator Visit Log from 7/22/26 to 7/29/26 will be submitted to the Department by POC due date.
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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.
SUPERVISOR'S NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5