342700914-3-12-2026-27-AS-LRIS-DSGVB4-20260324161657

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700914
Report Date: 03/12/2026
Date Signed: 03/12/2026 12:41:55 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
02/26/2026 and conducted by Evaluator Shakaricka Hughes

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20260226110153

FACILITY NAME:	POND BROOK HOME, INC.		FACILITY NUMBER:	342700914
ADMINISTRATOR:	CARPIO, ORLANDO		FACILITY TYPE:	735
ADDRESS:	8183 POND BROOK WAY		TELEPHONE:	(916) 476-0882
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95758
CAPACITY:	4	CENSUS: 4	DATE:	03/12/2026
		UNANNOUNCED	TIME BEGAN:	12:14 PM
MET WITH:	Facility Staff: Myrna Navarro		TIME COMPLETED:	12:55 PM

ALLEGATION(S):

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Staff hit resident.
Staff handled resident in a rough manner.
Staff inappropriately raised their voice at resident.

INVESTIGATION FINDINGS:

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On 3/12/2026 at 12:15 PM Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to the facility to conduct a complaint visit. LPA met with faciltiy staff Myrna and explained the purpose of the visit. The purpose of this visit is to deliver complaint findings for the allegations above. The current census is (4). The facility administrator was not present during today's visit.

Allegation: Staff hit a resident and staff handled a resident in a rough manner
It was alleged that staff hit a resident and staff handled a resident in a rough manner. This investigation consisted of interviews with facility staff and residents in care. On 3/4/2026 LPA Shakaricka Hughes conducted a visit to the facility, during the visit LPA spoke with (1) facility staff who stated that they have never hit a resident in care or ever observed another facility staff hit a resident or handle a resident roughly. LPA spoke with (2) residents in care who both denied allegations of ever being handled roughly by facility staff or ever being hit by facility staff.

Continuation 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026

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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Control Number 27-AS-20260226110153

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: POND BROOK HOME, INC.	FACILITY NUMBER: 342700914
	VISIT DATE: 03/12/2026

NARRATIVE

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Interview with resident (R1) stated that staff never hurt or grab them inappropriately and stated that they have never observed facility staff harm or grab other residents inappropriately. On 3/6/2026 LPA Hughes conducted a follow-up visit to the facility, during the visit LPA spoke with facility staff (S2) who stated that they usually work with resident (R1) on a 1:1 ratio and have never hurt or grabbed the resident roughly. Interview with resident (R2) had no concerns about facility staff ever grabbing or hurting them, stating that they feel safe with facility staff. There is not enough information or evidence present to corroborate this allegation; therefore, the allegation is unsubstantiated.

Allegation: Staff inappropriately raised their voice at resident

It was alleged that staff inappropriately raised their voice at a resident. This investigation consisted of interviews with facility staff and residents. On 3/4/2026 LPA Hughes conducted a visit to the facility, during the visit LPA spoke with facility staff (S1) who stated that sometimes facility staff raise their voice at residents to redirect or get the attention of residents when there is a conflict in the facility. Interview with resident (R1) stated that they have experienced facility yell at another resident in care but have never observed the facility staff curse at the resident. Interview with (2) residents in care stated that they have never observed facility staff speak to residents inappropriately or curse at residents. On 3/6/2026 LPA Hughes conducted a follow-up visit to the facility and interviewed resident (R2) who stated that facility staff have never yelled at them or cursed them. Additionally, LPA spoke with facility staff (S2) who stated that facility staff do not yell at residents, (S2) stated that they have raised their voice to gain the attention of residents when there is conflict in the facility, (S2) stated they have never cursed at residents or spoken inappropriately, or witnessed other staff speak inappropriately. There is not enough information or evidence present to corroborate this allegation; therefore, the allegation is unsubstantiated.

The investigation revealed the preponderance of evidence standards have not been met; therefore, the above allegations are found to be 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.

A brief interview with conducted with Myrna. A copy of this report will be emailed to the facility administrator.

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026

LIC9099 (FAS) - (06/04)

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