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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701155
Report Date: 07/01/2025
Date Signed: 07/01/2025 01:19:30 PM

Substantiated


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
06/24/2025 and conducted by Evaluator Vincent Moleski
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250624100909
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:
07/01/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Monalie Pascual-MercadoTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff do not meet training requirements.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Vincent Moleski and Office Technician Amy Jordan arrived unannounced to open this complaint investigation. LPA Moleski met with facility administrator Monalie Pascual and explained the purpose of the visit.

LPA Moleski reviewed four staff files (S1-S4) to ensure training and/or experience requirements were met. LPA Moleski observed that S1 did not complete initial medication training prior to working alone with clients. LPA Moleski reviewed S1's file and observed S1 was hired on 3/29/25. LPA Moleski reviewed staff schedules for the month of March and observed that S1 was working alone on NOC shifts on 3/29 and 3/30. S1 completed trainings on client rights, medication assistance, and health and emergency procedures on 4/4/25, after S1 was already working with clients alone, according to training records. According to Pascual-Mercado, all four clients of this facility have PRN medications on file. S1 completed training on incident and abuse reporting on 4/5. [continued on 9099-C]
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
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-20250624100909
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: 07/01/2025
NARRATIVE
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LPA Moleski confirmed that S2-S4 did complete their initial orientation and staff trainings prior to working alone with clients.

In an interview, Pascual Mercado agreed that all staff should complete all their initial training and orientation prior to working alone with clients. In a phone interview, licensee Jennifer Mercado agreed as well.

Title 22 of the California Code of Regulations (22 CCR) does not require Direct Support Professional (DSP) training to be completed prior to working alone with clients. 22 CCR Section 80065(f) states that staff must receive "on-the-job training ... which provides knowledge of and skill" in the area of medication assistance, among others. Additional training requirements are provided under Title 17 of the California Code of Regulations (17 CCR), which is not enforced by the California Department of Social Services (CDSS) Community Care Licensing Division (CCLD).

The department has determined the following as it relates to the allegation that staff do not meet training requirements:

Based on interviews and record review, the above allegation is SUBSTANTIATED. A finding that the complaint allegation is substantiated means that the allegation is valid because the preponderance of evidence standard has been met.

This facility is hereby cited per 22 CCR Section 80065(f). An exit interview was held with Pascual-Mercado. A copy of this report and appeal rights were left with Pascual-Mercado.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20250624100909
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: 07/01/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/08/2025
Section Cited
CCR
80065(f)
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"(f) All personnel shall be given on-the-job training ... which provides knowledge of and skill in the following areas, as appropriate to the job assigned..." This requirement was not met as evidenced by:
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Licensee agrees to provide LPA Moleski with an updated training plan for new hires by POC due date.
vincent.moleski@dss.ca.gov
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Based on record review, a staff member was working alone with clients, all of whom have PRN medications on file, prior to completing training on client rights, medication assistance, and emergency procedures, which poses a potential health, safety, and/or personal rights risk.
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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: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3