342700985-8-7-2026-27-AS-SRIN-DXKUNG-20260903154356

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700985
Report Date: 08/07/2026
Date Signed: 08/07/2026 04:43:21 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
04/10/2026 and conducted by Evaluator Christina Valerio

COMPLAINT CONTROL NUMBER: 27-AS-20260410145112

FACILITY NAME:	PRESTIGE CARE HOMES II		FACILITY NUMBER:	342700985
ADMINISTRATOR:	VIDAN BARIAS		FACILITY TYPE:	740
ADDRESS:	3405 HUNTSMAN DR		TELEPHONE:	(916) 802-7610
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95826
CAPACITY:	6	CENSUS: 3	DATE:	08/07/2026
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Cynthia Yuvienco		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff do not ensure residents are being served food of quantity to meet residents needs
Staff do not ensure there is the required amount of food in the home

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a complaint investigation and deliver complaint findings. LPA Valerio met with facility staff Cynthia Yuvienco, and explained the purpose of the visit. LPA Valerio contacted Administrator Vidan Barias, who designated staff to sign on her behalf

The investigation consisted of resident interviews, staff interviews, observations of food supply, and record review of pictures and facility files.

The reporting party alleged that Resident 1 (R1) is not being fed at the care home. The RP reported that on Easter they had provided R1 with a sandwich with Mayo on it and nothing else. RP reported that the fridge was empty.

Continues on LIC 9099 - C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026

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-20260410145112

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: PRESTIGE CARE HOMES II	FACILITY NUMBER: 342700985
	VISIT DATE: 08/07/2026

NARRATIVE

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On 04/16/2026, LPA Valerio conducted an unannounced visit to interview residents and observe the facility. LPA Valerio observed R1 in the living room in R1's hospital chair. R1 was being fed by staff during lunch time. LPA Valerio observed the resident and other resident during lunch time.

According to resident interviews conducted, the facility provided a lot of food, sometimes too much, and had no concerns with the food. According to staff interviews, the staff stated they always have food. According to Staff 1 (S1), S1 does not remember what S1 served on Easter Sunday, but S1 usually makes sandwiches. LPA asked what does S1 put in the sandwich. S1 stated S1 puts mayo, lettuce, tomato, and chicken. Sometimes S1 will put turkey, bacon, or roast beef depending on what they have from the store. S1 serves it with a salad and fruit or cut vegetables.

LPA Valerio observed the following food on 04/16/2026. LPA Valerio observed two refrigerator/freezer and a pantry. The first fridge had the following 8 Marie calendar chicken pot pie, a family size bad of frozen mix vegetables, two frozen packs of hot dogs, 1 family size bag of chicken thighs, one frozen family size bag of breakfast sausage, 2 small bags of mixed vegetables, 1 big frozen ground beef roll, 3 gallons of juice, 2 gallons of milk, 2 large bunch of strawberries, 3 loaves of bread, 1 family size of hamburger buns, 1 family size of hot dogs, 2 - 5 dozen box of eggs, fresh cabbage, 1 bunch of carrots, 20 pudding cups, and condiments. The second fridge had two sections. The refrigerator had two dozen of eggs, a bag of avocados, a bag of cut potatoes, two boxes of butter, soda, 12 jars of yogurt, and 1 jar of pasta. The freezer had two family size mixed vegetables, 1 family size box of orange chicken, 1 family size frozen uncooked shrimp, multiple bags of frozen protein items, and 6 bags of frozen waffles. The pantry was observed to have the following: 3 large jugs of vinegar, 2 - 35 cans of coca cola soda, 24 pack of cup noodles, 4 gallons of juice, 1 large jar of mayo, over 20+ cans of canned food, 6 boxes of tru-blue saltine crackers, 3 boxes of breakfast cereal, bananas, chocolate chip cookies, 4 family size bags of pasta noodles, and 6 boxes of rice roni.

Licensing Program Analyst (LPA) Christina Valerio received pictures from Administrator Vidan regarding the food plates that were provided to R1. The administrator stated the concern of R1 not eating was brought up so they started taking pictures and sending it to the case manager and the family. According to Administrator, R1 would eat full plates and snacks but would say R1 was hungry.

Continues on LIC 9099, page 3

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 27-AS-20260410145112

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: PRESTIGE CARE HOMES II	FACILITY NUMBER: 342700985
	VISIT DATE: 08/07/2026

NARRATIVE

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Picture 1 - The picture had 6 pieces of breaded chicken placed on the plate. Each chicken was the size of a silver dollar. There were also cut up boiled potatoes with seasoning and Cut up asparagus that appeared to be steamed or sauteed.

Picture 2 - The protein appeared to be orange chicken (7 pieces), steamed vegetables, and rice pilaf.

Picture 3 - 4 triangle pieces of a grilled sandwich filled with sliced cheese, mayo, sliced ham, and scrambled eggs. Flake cereal served with milk and sliced bananas.

Picture 4 - Pancit noodles with vegetables, egg, and chicken served with a chocolate cake loaf.

Picture 5 - Swedish meatball with peas, gravy, and mash potatoes served with a chocolate pudding cup.

On 08/07/2026, LPA Valerio conducted an unannounced visit to conduct an annual required visit. During the annual visit, LPA Valerio observed the facility to have a minimum food supply to meet the requirements of two days of perishable food items and seven days of non-perishable food items. LPA Valerio observed watermelon, bananas, and oranges available for residents. LPA Valerio observed frozen ground beef, chicken, salmon, chicken patties, and lasagna trays in the freezer. LPA Valerio observed milk, juice, condiments, mixed salad bag, zucchini, bread, cheese slices, fruit jam, peanut butter, butter, macaroni salad, onions, tomatoes, and eggs in the refrigerator.

Based on all the information collected by the Department, although the allegation may have happened or is valid, here is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED.

Per 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 with staff Cynthia.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2026

LIC9099 (FAS) - (06/04)

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