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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701159
Report Date: 08/18/2026
Date Signed: 08/18/2026 02:27:03 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
06/23/2026 and conducted by Evaluator Melina Oropeza
COMPLAINT CONTROL NUMBER: 27-AS-20260623140406
FACILITY NAME:BEATRICE SENIOR CAREFACILITY NUMBER:
342701159
ADMINISTRATOR:CLARK, TIMOTHYFACILITY TYPE:
740
ADDRESS:8901 MELODIC CTTELEPHONE:
(916) 270-3961
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:6CENSUS: 4DATE:
08/18/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Beatrice ClarkTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff did not notify payee of resident's death
Staff did not refund payee after resident's death
Staff is not answering payee's calls
INVESTIGATION FINDINGS:
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On 08/18/26, Licensing Program Analyst (LPA) Melina Oropeza made an unannounced visit to this facility to continue a complaint investigation for the above allegations. LPA identified themselves upon arrival, stated the purpose of their vist to staff. Administrator, Betrice Clark was called and joined 15 minutes later and LPA stated the purpose of the visit.

Staff did not notify payee of resident’s death based on records reviewed confirmed the payee was not notified by the facility of R1’s death. Based on records reviewed and information obtained, the allegation is SUBSTANTIATED.

Staff did not refund payee after resident’s death based on records confirmed R1 passed away on 04/24/2026 and the facility received payment for May 2026. Documentation showed multiple attempts were made to obtain a refund; however, the refund was not issued within the required timeframe. Based on records reviewed and information obtained, the allegation is SUBSTANTIATED.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
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-20260623140406
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: BEATRICE SENIOR CARE
FACILITY NUMBER: 342701159
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2026
Section Cited
CCR
1569.652(c)
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Health and Safety Code §1569.652(c) – Refund of Fees Paid A refund of fees paid in advance covering the period after the resident’s personal property has been removed from the facility shall be issued to the individual or entity contractually responsible for the fees within 15 days after the property is removed.
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Licensee shall issue the refund and submit proof of payment to CCLD by the POC date 09/01/26 by 5:00pm. Licensee shall also submit a written procedure describing how refunds following a resident’s death will be processed within the required timeframe to ensure future compliance.
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Based on records reviewed, the licensee failed to issue the required refund of prepaid fees within the required timeframe following R1’s death. Records documented multiple attempts by the payee to obtain the refund; however, the refund remained outstanding.
This poses a potential personal rights risk to residents in care.
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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.
SUPERVISOR'S NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20260623140406
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: BEATRICE SENIOR CARE
FACILITY NUMBER: 342701159
VISIT DATE: 08/18/2026
NARRATIVE
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Staff is not answering payee’s calls based on records reviewed documented multiple unsuccessful attempts by the payee to contact facility representatives regarding R1 and the outstanding refund, including calls that were not answered or returned. Based on records reviewed and information obtained, the allegation is SUBSTANTIATED.

Based on records reviewed, the the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

Citations are being issued today per California Code of regulation Title 22 see 9099-D page.

An exit interview was held, and a copy of this report and appeal rights was provided to administrator, Beatrice Clark
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3