342701218-1-22-2026-27-AS-CACL-DQLVV5-20260123154547

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342701218
Report Date: 01/22/2026
Date Signed: 01/22/2026 03:57:31 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
08/25/2025 and conducted by Evaluator Shakaricka Hughes

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20250825132439

FACILITY NAME:	ROYAL GROVE CARE HOME		FACILITY NUMBER:	342701218
ADMINISTRATOR:	ROSA ELMA QUIAMBAO		FACILITY TYPE:	740
ADDRESS:	9559 LAZY SADDLE WAY		TELEPHONE:	(916) 829-4117
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	0	CENSUS: 5	DATE:	01/22/2026
		UNANNOUNCED	TIME BEGAN:	03:20 PM
MET WITH:	Facility Administrator: Gladys Quiambao		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff caused multiple injuries to resident.
Staff handled resident in a rough manner.

INVESTIGATION FINDINGS:

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On 01/22/2026 at 3:15 PM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived unannounced to this facility to conduct a complaint visit. LPA met with the facility administrator Gladys 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 5.

Allegation: Staff caused multiple injuries to resident.
It was alleged that staff caused multiple injuries to a resident. This investigation consisted of interviews with facility staff, residents and facility observation. On 01/14/2026 LPA Hughes conducted a visit to the facility and spoke with facility staff (S1) who stated that resident (R1) skin is very soft, and that they easily bruise. S1 stated that, at the time of the incident R1’s nurse was new to working with R1 and was not familiar with their history of bruising. Interview with facility staff (S2) stated that they attempted to redirect R1, which caused a conflict with R1 pushing S2 while they were trying to assist R1 with taking a seat.

Continuation 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Shakaricka Hughes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20250825132439

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: ROYAL GROVE CARE HOME	FACILITY NUMBER: 342701218
	VISIT DATE: 01/22/2026

NARRATIVE

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Facility staff S2 stated that R1’s nurse has informed facility staff not to hold the resident by their arms as the resident skin is soft, and they easily bruise. Interview with 2 out of 4 residents in care expressed no concerns with ever observing facility staff harm other residents in care or harm them. LPA attempted to interview resident (R1) but was unable as the resident has very limited English-speaking capabilities. LPA attempted to contact the Reporting Party (RP) several times but never received a call back. LPA observed resident (R1) in the facility, they appeared calm and responsive to facility staff. Facility staff (S1) showed LPA R1’s arms which appeared normal, without any visible signs of injury. There is not enough evidence to corroborate this allegation, therefore the allegation is unsubstantiated.

Allegation: Staff handled resident in a rough manner.
It was alleged that staff handled a resident in a rough manner. This investigation consisted of interviews with facility staff, residents and facility observation. On 1/14/2026 LPA Hughes conducted a visit to the facility and spoke with facility staff (S1) who stated that resident (R1) has calmed down while residing in the facility, stating that R1 medications have changed and the facility no longer has daily challenges with the resident. S1 denied allegations of ever observing a facility staff handle a resident roughly. Interview with facility staff (S2) stated that they have never handled any residents roughly, stating that all residents are treated and handled with care. Facility staff (S2) stated that in the past resident (R1) would inflict physical assault on staff, but their temperament has become more responsive to facility staff. Facility staff (S2) stated that R1’s nurse has informed staff to handle the resident from different angles to prevent bruising. Interview with 2 out of 4 residents did not express any concerns about ever observing a facility staff handle a resident in a rough manner or ever being handled roughly themselves. LPA attempted to interview resident (R1) but was unable as they have limited English speaking capabilities. LPA attempted to speak with the Reporting Party several times but never received a return call. During the visit on 1/14/2026 LPA observed facility staff preparing dinner, and assisting residents to the dining area. Due to insufficient evidence, this 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: 01/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2026

LIC9099 (FAS) - (06/04)

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