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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701155
Report Date: 04/29/2026
Date Signed: 04/30/2026 09:07:33 AM

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
03/10/2026 and conducted by Evaluator Shakaricka Hughes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260310105635
FACILITY NAME:MILESTONE CAREHOME INCFACILITY NUMBER:
342701155
ADMINISTRATOR:MONALIE PASCUAL-MERCADOFACILITY TYPE:
735
ADDRESS:9001 GENERATIONS DRTELEPHONE:
(916) 478-0478
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:4CENSUS: 4DATE:
04/29/2026
UNANNOUNCEDTIME BEGAN:
01:09 PM
MET WITH:Administrator: Monalie Pascual - MercadoTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff isolate client to their room
Staff do not ensure that clients are adequately supervised to prevent over consumption of food
Staff provoke clients to misbehave
Facility staff are smoking on the premises
INVESTIGATION FINDINGS:
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On 04/29/2026 at 1:15 PM Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with Monalie 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.

Allegation: Staff Isolate client to their room
It was alleged that facility staff isolate clients in their room. This investigation consisted of interviews with facility staff, clients and facility observations. On 3/16/2026 LPA Hughes conducted an unannounced visit to the facility and interviewed 6 facility staff. All staff denied isolating clients in their rooms and reported they have not observed any client being isolated. LPA interviewed 1 out of 3 clients in care, who stated that staff have not isolated them to their room. During the facility tour, LPA observed 2 clients outside of their rooms engaging in normal daily activities and 1 client inside of their room. There were no observations indicating that clients were being restricted or isolated to their rooms. On 4/3/2026 LPA Hughes conducted a follow-up visit to the facility.

Continuation 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
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 6
Control Number 27-AS-20260310105635
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: MILESTONE CAREHOME INC
FACILITY NUMBER: 342701155
VISIT DATE: 04/29/2026
NARRATIVE
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 LPA observed (2) clients in the facility with their doors open, walking around the facility with the assistance of facility staff. Based on the evidence gathered, there is insufficient evidence to support the allegation, therefore the allegation is unsubstantiated.

Allegation: Staff do not ensure that clients are adequately supervised to prevent overconsumption of food

It was alleged that staff do not ensure that clients are adequately supervised to prevent over-consumption of food. This investigation consisting of interviews with facility staff, clients, and facility observations. On 3/16/2026 LPA Hughes conducted an unannounced visit to the facility and interviewed 6 out of 7 facility staff, who stated that they have not observed or allowed clients to over consume food in the facility, stating that all clients are placed on a 1:1 or 2:1 ratio with facility staff. Interview with 1 out of 3 clients stated that facility staff cook for them, and that they are being served an adequate amount of food. LPA toured the facility, and observed clients being supervised by facility staff on a 1:1 ratio. On 04/03/2026 LPA Hughes conducted a follow-up visit to the facility and observed client (C2) being assisted by a facility staff, LPA observed facility staff assisting the client with preparing a snack. Based on the evidence gathered, there is insufficient evidence to support the allegation, therefore the allegation is unsubstantiated.

Allegation: Staff provoke clients to misbehave

It was alleged that staff provoke clients to misbehave. This investigation consisted of interviews with facility staff, clients, and outside parties. On 3/16/2026 LPA Hughes conducted an unannounced visit to the facility and interviewed 6 out of 7 facility staff who stated that that they have not observed any facility staff provoke residents to misbehave. Additionally, interview with facility staff (S7) stated that they have never provoked clients to misbehave, stating that they seek guidance from the client behaviorist regarding redirection tactics. An interview conducted with the Alta Service Coordinator revealed no reported concerns regarding staff threatening clients with physical harm or provoking clients to misbehave. Further stating that no concerning behaviors regarding clients were observed during their facility visits. Based on the evidence gathered, there is insufficient evidence to support the allegation, therefore the allegation is unsubstantiated.

Continuation 9099- C

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 27-AS-20260310105635
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: MILESTONE CAREHOME INC
FACILITY NUMBER: 342701155
VISIT DATE: 04/29/2026
NARRATIVE
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Allegation: Facility staff are smoking on the premises

It was alleged that facility staff are smoking on the premises. This investigation consisted of interviews with facility staff and clients. On 3/16/2026 LPA Hughes conducted an unannounced visit to the facility and interviewed 6 out of 7 facility staff who stated that they have never observed a facility staff smoke on the premises of the facility or ever observed a facility staff smoke around a client in care. Additional interview with facility staff (S2) stated that they have observed a box of cigarettes left in the facility and have addressed the concerns with staff working in the facility. Interview with 1 out of 3 clients in care stated that they have not observed staff smoke in the facility, or smoke in front of them. Based on the evidence gathered, there is insufficient evidence to support the 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.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
03/10/2026 and conducted by Evaluator Shakaricka Hughes
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260310105635

FACILITY NAME:MILESTONE CAREHOME INCFACILITY NUMBER:
342701155
ADMINISTRATOR:MONALIE PASCUAL-MERCADOFACILITY TYPE:
735
ADDRESS:9001 GENERATIONS DRTELEPHONE:
(916) 478-0478
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:4CENSUS: 4DATE:
04/29/2026
UNANNOUNCEDTIME BEGAN:
01:09 PM
MET WITH:Administrator: Monalie Pascual - MercadoTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Staff used an object to threaten client with physical harm
INVESTIGATION FINDINGS:
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On 04/29/2026 at 1:15 PM Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with Monalie 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.

Allegation: Staff used an object to threaten client with physical harm
It was alleged that staff hold a wooden coat hanger by their side to intimidate residents and get them to comply with staff. This investigation consisted of interviews with facility staff. On 3/16/2026 LPA Hughes conducted an unannounced visit to the facility and interviewed 6 out of 7 facility staff. Interview with Facility staff (S2) reported observing staff (S4) grab a hanger and took client (C2) into the room closed the door, and she heard a loud smack. S2 further stated that the facility administrator have previously reminded staff not to use objects in a manner that could be perceived as intimidating. S2 stated that when they first started working at the facility, a former employee informed them to use hangers to intimidate residents. S2 stated that facility staff S4, S5, and S6 all use hangers to intimidate residents.

Continuation 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 27-AS-20260310105635
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: MILESTONE CAREHOME INC
FACILITY NUMBER: 342701155
VISIT DATE: 04/29/2026
NARRATIVE
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During a follow-up visit to the facility on 04/03/2026 LPA Hughes conducted an interview with facility staff (S8) who reported observing staff (S4) holding a hanger when working with clients. This was observed not in compliance with Title 22 regulation 80072(a)(3) Personal Rights, as the facility did not ensure residents were free from actions that could be perceived as intimidating or punitive in nature.

As a result, this 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. An exit interview was conducted and a copy of the LIC 9099, LIC 9099-D pages and appeal rights were provided to facility.
 
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 27-AS-20260310105635
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: MILESTONE CAREHOME INC
FACILITY NUMBER: 342701155
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/30/2026
Section Cited
CCR
80072(a)(3)
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80072 Personal Rights (a)Except for... each client shall have personal rights which include, but are not limited to, the following (3)To be free from...intimidation..other actions of a punitive nature, including but not limited to: interference with the daily living functions...

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The facility administrator stated that they will terminate facility staff (S4) (S5) (S6) effective immediately. The administrator stated that they will remove all staff identified from the LIC 500 and disassociate the staff in Guardian.
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This requirement was not met as evidenced by:
The facility did not ensure residents were free from actions that could be perceived as intimidating or punitive in nature. Facility staff (S4) was observed holding a wooden hanger to intimidate client (C2) which poses an immediate safety and personal rights risk to clients in care.
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The administrator stated that they will consult with Alta Regional regarding training for Client Abuse and Personal Rights. The administrator will send proof of dissociation of facility staff by 05/04/2026. Once training is completed the administrator will provide proof of training.

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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.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6