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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345003013
Report Date: 12/16/2025
Date Signed: 12/16/2025 04:12:26 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/21/2025 and conducted by Evaluator Bethany Mirlohi
COMPLAINT CONTROL NUMBER: 59-AS-20251021163042
FACILITY NAME:ANGELS ASSISTED LIVING,INC.FACILITY NUMBER:
345003013
ADMINISTRATOR:BHATIA, SIMRANJITFACILITY TYPE:
740
ADDRESS:1526 CRESTMONT OAK DRIVETELEPHONE:
(916) 841-9449
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:6CENSUS: 4DATE:
12/16/2025
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Simranjit Bhatia, AdministratorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff not repositioning resident per care needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to deliver complaint investigation findings into allegation listed above. LPA spoke to administrator Simranjit Bhatia during today’s visit.

LPA investigated allegation, “Staff not repositioning resident per care needs”. LPA reviewed facility documents and interviewed staff and residents in care. Reporting party indicated that R1 reported that staff do not reposition them which causes them discomfort. LPA interviewed caregivers in which they stated they repositioned R1 every hour, unless R1 refused. Caregivers stated resident had behaviors of yelling out and being combative during care. LPA interviewed 2 residents in care in which they stated they heard R1 yell out from their room, especially during the night.

Continuation on 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
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 2
Control Number 59-AS-20251021163042
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
FACILITY NAME: ANGELS ASSISTED LIVING,INC.
FACILITY NUMBER: 345003013
VISIT DATE: 12/16/2025
NARRATIVE
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LPA reviewed R1’s LIC602 in which it states resident requires assistance with repositioning and transferring and resident has a history of skin breakdown. In addition, the LIC602 states R1 has a lack of hazard awareness and has expressions of frustration. LPA reviewed R1’s needs and service plan dated 6/5/25, in which it states R1 has behaviors of yelling out and being confused and R1 requires assistance with all ADL’s. R1 no longer lives at the facility and LPA was unable to interview R1. Due to the information gathered, LPA finds allegation to be UNSUBSTANTIATED.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are unsubstantiated.

Deficiencies were found, unrelated to allegation, due to investigation. See Case management visit.

Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2