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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345003013
Report Date: 05/28/2025
Date Signed: 05/28/2025 03:31:20 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, 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
03/18/2025 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20250318082622
FACILITY NAME:ANGELS ASSISTED LIVING,INC.FACILITY NUMBER:
345003013
ADMINISTRATOR:BHATIA, SIMRANJITFACILITY TYPE:
740
ADDRESS:1526 CRESTMONT DRTELEPHONE:
(916) 841-9449
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:6CENSUS: 1DATE:
05/28/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Administrator Simranjit BhatiaTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Unlawful eviction.
Do to neglect, resident sustained a pressure injury.
INVESTIGATION FINDINGS:
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On 05/28/25, Licensing Program Analysts (LPAs) Talwinder Bains and Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met Administrator Simranjit Bhatia and explained the purpose of today's visit.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

**Report continued on 9099-C**
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
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-20250318082622
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ANGELS ASSISTED LIVING,INC.
FACILITY NUMBER: 345003013
VISIT DATE: 05/28/2025
NARRATIVE
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**Report continued from 9099......

Allegation- Unlawful Eviction- UNSUBSTANTIATED

LPA investigated allegation "unlawful eviction" and interviewed administrator. Administrator stated resident, R1 got admitted to facility on 01/06/23 and was transferred out to hospital on 04/12/24 due to change in condition. Administrator stated that R1 was very challenging with their care needs. Administrator stated they verbally informed R1s responsible party and placement agency that new placement was needed but a written 30-day notice was not given to R1. In April 2024, R1 was sent out to the emergency department. R1 needed to be discharged and administrator contacted R1 to discuss house rules via phone if R1 willing to return but R1 declined to follow any house rules and refused to return to facility. it was learnt that R1 was willingly moved to another facility after hospital discharge. Based on gathered information, this allegation was found to be UNSUBSTANTIATED.

Allegation -Do to neglect, resident sustained a pressure injury. UNSUBSTANTIATED

Department conducted record review and interviews with staff and witnesses to investigate this allegation. Record review reflected that resident, R1 got admitted to facility on 01/06/23 and was transferred out to hospital on 04/12/24 due to change in condition. It was also noted that R1 was on hospice care from 01/16/23 till 02/14/24 and on home health care from 02/16/24 till their hospital visit on 04/12/24. Record review reflected that R1 has wound care treatment during their facility stay and all parties were aware about those health issues. Administrator and 2 witnesses interviews reflected that R1 was not complaint with their wound care plan, but it was not due to staff’s neglect or supervision. Based on gathered information, this allegation was found to be UNSUBSTANTIATED.

A finding that the complaint allegations is UNSUBSTANTIATED means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred.

Exit meeting conducted. A copy of this report has been provided to facility.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2