342700903-9-28-2026-27-AS-SRIN-DZC2NT-20261029173315

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700903
Report Date: 09/28/2026
Date Signed: 09/28/2026 04:29:33 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
01/12/2026 and conducted by Evaluator Christina Valerio

COMPLAINT CONTROL NUMBER: 27-AS-20260112094019

FACILITY NAME:	EHIMAS RESIDENTIAL CARE		FACILITY NUMBER:	342700903
ADMINISTRATOR:	STEPHANIE SIEWE		FACILITY TYPE:	740
ADDRESS:	407 MAPLE STREET		TELEPHONE:	(916) 912-8042
CITY:	GALT	STATE: CA	ZIP CODE:	95632
CAPACITY:	15	CENSUS: 10	DATE:	09/28/2026
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Stephanie Siewe		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff are not providing care and supervision
Staff do not ensure the residents call lights are properly operating
Staff are not meeting a resident's catheter needs
Staff are not meeting a resident's dietary needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannounced to conduct a complaint investigation and deliver complaint allegation findings. LPA Valerio met with facility staff, and explained the purpose of the visit. LPA Valerio notified Administrator Stephanie Siewe via cell phone and was later met by administrator at the facility.

The following has been determined as it relates the aforementioned allegations. During the course of the investigation, LPA Valerio conducted interiews with staff, interviews with residents, interview with outside parties, reviewed facility documentation, and observed the facility.

Allegation: Staff are not providing care and supervision
Continues on LIC 9099 - C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026

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 27-AS-20260112094019

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: EHIMAS RESIDENTIAL CARE	FACILITY NUMBER: 342700903
	VISIT DATE: 09/28/2026

NARRATIVE

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Allegation: Staff are not providing care and supervision

LPA Valerio interviewed six (6) residents. Two out of the six interviews conducted revealed that there are some staff members that have told a resident to wait to be changed. Residents were not able to identify the staff members who have told them to wait until the next shift and/or for their nurse to come. Residents also stated that this was an issue before but it is not one now. One out of six residents did not want to elaborate on their care at Ehimas Residential.

LPA Valerio reviewed facility documentation for change log. LPA Valerio observed seven (7) residents on the change log. In a 24 hour period, LPA Valerio observed two to four entries per day. LPA Valerio observed the change log for January 2026.. According to the log, a resident was changed on the following dates and times: 12/17/25 6:10 AM, 7:10 AM, 6:17 PM, 12/18/2025 4:10 PM, 2:10 PM, 12/192025 2:00 PM, and 12/20/2025, 8:15 PM, 5:25 PM, 11;40 PM. If these times were accurate, the resident would have been left soiled for over a 12-hour period.

LPA Valerio attempted to interview five (5) staff members. LPA Valerio was able to successfully interview three out five. Based on staff interviews, staff shared that residents are changed during the night by NOC staff members and that their are two staff on shift. LPA Valerio attempted to interview a staff that filled out the change log; however, that person indicated that they never worked for Ehimas Residential.

Allegation: Staff do not ensure the residents call lights are properly operating

LPA Valerio observed the facility on January 16, 2026 and September 28, 2026. LPA Valerio did not observe a call light system. LPA Valerio interviewed three staff members. According to staff, staff stated they had call lights but do not use them. Another staff member stated, the facility never had a call light system. According to interview with residents in care, the residents stated that if they need assistance, they call out for staff.

Continues on LIC 9099 - C..

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 27-AS-20260112094019

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: EHIMAS RESIDENTIAL CARE	FACILITY NUMBER: 342700903
	VISIT DATE: 09/28/2026

NARRATIVE

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Allegation: Staff are not meeting a resident's catheter needs

Based on an interview with staff, their are two residents with catheter needs. LPA Valerio reviewed facility documentation for Resident 2 (R2). Based on records review, staff and resident were trained on safety measures and care for the catheter. Based on interviews with resident and staff, the home health order expired. Based on interviews with staff, staff informed LPA Valerio that they were trained on catheter care as soon as the patient arrived. According to an interview with staff, staff stated if they have a person needed catheter care, they provide bed baths, empty the bag, and clean around the tube. Staff expressed that they have enough hygiene supplies and/or cleaning agents to care for the catheter.

Allegation: Staff are not meeting a resident's dietary needs

LPA Valerio observed the LIC 602, home health orders, and appraisal/service and needs form. According to home health orders, R2 is to be on a high fiber, no added salt diet. According to the LIC 602 and Appraisal, R2 is not on a modified diet. According to a review of the home health orders, the orders expired on January 29, 2026.

LPA Valerio interviewed six (6) residents. All resident interviews indicated that they food is not good, okay, so-so, or good. According to an interview with an outside agency, they expressed that the food at the facility was said to be worst than prison food. The facility does not give any vegetables and sometimes they put hot dogs on nachos. According to staff interviews, staff stated they try to variety of meals and give soup, sandwiches, meats, rice, pasta, variety. It is balanced. Staff stated if they run out of an ingredient, they will use what they have in the home.

LPA Valerio observed the facility menu to have three meals and two snacks per day. The meals appeared balance as each meal had a carbohydrate, protein, and vegetable. The menu did not appear to have only frozen meals and noted meals that require being homemade

Based on all the information collected by the Department, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited. An exit interview was held and a copy of report was left at the facility.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2026

LIC9099 (FAS) - (06/04)

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