345920066-5-20-2026-59-AS-LMUZ-DUAN2K-20260521100450

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345920066
Report Date: 05/20/2026
Date Signed: 05/20/2026 09:56:58 AM

Unfounded

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
05/15/2026 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 59-AS-20260515101111

FACILITY NAME:	VAN MOORE VILLA		FACILITY NUMBER:	345920066
ADMINISTRATOR:	NICULAI, SEFORA		FACILITY TYPE:	740
ADDRESS:	8924 VAN MOORE LANE		TELEPHONE:	(916) 218-8355
CITY:	ORANGEVALE	STATE: CA	ZIP CODE:	95662
CAPACITY:	6	CENSUS: 6	DATE:	05/20/2026
		UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Administrator, Sefora Niculai		TIME COMPLETED:	10:10 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee does not keep accurate personnel records.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Talwinder Bains arrived at the care home today and met with the Administrator, Sefora Niculai to open and deliver complaint investigation findings regarding the above stated allegation.

During today's visit, LPA conducted interviews and reviewed documentation pertinent to the investigation. LPA reviewed all staff files and found all staff to be criminal background cleared and to have complete personnel files. Interviews with Administrators and staff (S1 and S2) indicated that the staff working in the care home matched the Personnel Report LIC500.

Based on documentation obtained and interviews conducted, the above allegations are found to be UNFOUNDED. A finding that the allegations are unfounded means that the allegations are false, could not have happened, and/or are without a reasonable basis. No deficiencies are being cited.
Exit interview conducted. A copy of the report was provided.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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 1