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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700925
Report Date: 05/27/2026
Date Signed: 05/27/2026 11:13:06 AM

Unsubstantiated


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
02/12/2026 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20260212164311
FACILITY NAME:VILLA NATOMAS ELDERLY CARE LLCFACILITY NUMBER:
342700925
ADMINISTRATOR:WILLIAMS, BARBARAFACILITY TYPE:
740
ADDRESS:540 ALCANTAR CIRTELEPHONE:
(916) 832-3626
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY:6CENSUS: 6DATE:
05/27/2026
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:caregiver Walesi VakararawaTIME COMPLETED:
11:25 AM
ALLEGATION(S):
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9
The facility allowed excluded individuals to work in the facility.

The Administrator is not present at the facility for a sufficient amount of time.
INVESTIGATION FINDINGS:
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On 5/27/26, Licensing Program Analysts (LPA)s Kevin Mknelly and Kerry Hiratsuka conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with caregiver. Administrator was call and unavailable.

LPA conducted records review .
LPA is unable to find and or meet the preponderance, per policy.
LPAs did not find evidence of excluded individuals working at this home.
LIC 602- Physician reports, and other documents present did not show signs of forgery.
No significant evidence was found that Administrator duties and respobsibilities are not fulfilled.

As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint 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.
Exit interview withcaregiver.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026
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 2
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
02/12/2026 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20260212164311

FACILITY NAME:VILLA NATOMAS ELDERLY CARE LLCFACILITY NUMBER:
342700925
ADMINISTRATOR:WILLIAMS, BARBARAFACILITY TYPE:
740
ADDRESS:540 ALCANTAR CIRTELEPHONE:
(916) 832-3626
CITY:SACRAMENTOSTATE:CAZIP CODE:
95834
CAPACITY:6CENSUS: 6DATE:
05/27/2026
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:caregiver Walesi VakararawaTIME COMPLETED:
11:25 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are forging resident documents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 5/27/26 , Licensing Program Analysts (LPAs) Kevin Mknelly and Kerry Hiratsuka LPA Mknelly arrived and met with Administrator to deliver investigation findings.

LPA reviewed facility records, and resident records.
LPA finds that facility met Tittle 22 requirements.

.LIC 602- Physician reports, and other documents present did not show signs of forgery.

This agency has investigated the above complaint allegations. We have found that the complaint is UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Exit interview conducted and report provided.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2