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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345920121
Report Date: 07/30/2025
Date Signed: 07/30/2025 10:14:50 AM

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
03/25/2025 and conducted by Evaluator Kevin Mknelly
COMPLAINT CONTROL NUMBER: 59-AS-20250325150542
FACILITY NAME:HARJIT AND NAVGEET RCFE IIFACILITY NUMBER:
345920121
ADMINISTRATOR:KAUR, NAVGEETFACILITY TYPE:
740
ADDRESS:4400 BELMONT PLACE LANETELEPHONE:
(916) 514-8957
CITY:SACRAMENTOSTATE: CAZIP CODE:
95841
CAPACITY:6CENSUS: 6DATE:
07/30/2025
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Caregiver/ designeeTIME COMPLETED:
10:20 AM
ALLEGATION(S):
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Resident sustained an unexplained fracture while in care
Staff handled resident in a rough manner
INVESTIGATION FINDINGS:
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On July 30. 2025, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and spoke with Admin by phone.

The department conducted records review and extensive interviews.
The department is unable to find and or meet the preponderance, per policy.

Interviews conducted found that on 3/16/25, R1 was observed to be limping and have a swollen toe. R1’s responsible party was notified and it was decided to have the condition assessed in a scheduled 3/19/25 podiatrist appointment. On 3/19/25, a right great toe fracture was found in x-ray. R1 was unable to state the cause of the injury.

R1’s representative stated when interviewed that they did not believe the injury was caused intentionally by staff. Report continued....
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
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-20250325150542
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: HARJIT AND NAVGEET RCFE II
FACILITY NUMBER: 345920121
VISIT DATE: 07/30/2025
NARRATIVE
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Records review for R1 found that R1 is diagnosed with dementia, osteoporosis, multiple sclerosis and needs assistance when ambulating.

Regarding the allegation of staff (S1) handling R1 roughly, interviews found that there was a disagreement between S1 and R1’s representative regarding S1’s handling of R1 during an incontinence incident. R1’s representative described S1 moving to fast during care. S1 stated they were following R1’s care plan for level of assistance. Administrator accommodated representative’s request that S1 only care for R1 with other staff assist.

In interview with R1, R1 stated that he likes living at this home.
Other resident interviewed stated that they receive good care and no mistreatment of residents were observed.
Interviews of staff found that R1 is well cared for and every attempt is made to accommodate to R1’s representatives reasonable requests.

As a result of this investigation, LPA finds allegation to be (US)Unsubstantiated - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.


Exit interview with administrator report copy provided.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2