347001571-1-2-2026-27-AS-SRIN-DR6PGD-20260210101808

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347001571
Report Date: 01/02/2026
Date Signed: 01/02/2026 10:40:41 AM

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
12/23/2025 and conducted by Evaluator Arvin Villanueva

COMPLAINT CONTROL NUMBER: 27-AS-20251223090050

FACILITY NAME:	RICHBOROUGH FOUNTAIN, INC.		FACILITY NUMBER:	347001571
ADMINISTRATOR:	SALVADOR, RYAN		FACILITY TYPE:	735
ADDRESS:	9038 RICHBOROUGH WAY		TELEPHONE:	(916) 685-1194
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	6	CENSUS: 5	DATE:	01/02/2026
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Mohit Singh		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff hit a client resulting in injury.

INVESTIGATION FINDINGS:

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

On 1/2/2026, Licensing Program Analyst, Arvin Villanueva (LPA) arrived unannounced at this facility to conduct a follow-up complaint investigation and to deliver findings regarding the allegation that staff hit a client resulting in injury. LPA initially met with staff on duty (S2) and stated the purpose of the visit. The facility manager, Josephine Shobhna (S1),was notified and arrived shortly after. Present during this visit were 2 clients in care with 2 staff on duty. The other clients were out in the community.

Throughout this investigation, LPA interviewed facility staff, day program staff, and Client R4, reviewed facility records, and conducted observations at both the facility and R4’s day program.

{1 of 3}

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2026

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 3

Control Number 27-AS-20251223090050

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: RICHBOROUGH FOUNTAIN, INC.	FACILITY NUMBER: 347001571
	VISIT DATE: 01/02/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Night staff working on 12/15/25 reported that the injuries on R4’s right hand—scabs on the index, middle, and ring fingers—happened when R4 tried to open a locked kitchen drawer. Staff explained that the drawer holds sharp items, like kitchen knives, and R4 hurt themselves while trying to force it open. Other staff that were interviewed on 12/24/25 also said that R4 has a history of making false claims. They described this as “lying,” “making up stories,” and “making up names.” Staff said R4 sometimes says that staff or other clients hit R4, but these claims have not been found to be true. Day program staff that were interviewed on 12/24/25 also confirmed that R4 often makes false statements, including saying that staff hit R4. When these claims are checked, they are always found to be untrue.

LPA interviewed R4 during a collateral visit at a day program on 12/24/25. During the interview, R4 gave different explanations for the finger injuries. First, R4 said they hit themselves. Later, R4 said a staff member hit their hand. When asked who, R4 said, “Tina hit with a stick,” but when asked who Tina was, R4 said, R4 “scratch.” R4 was very distracted during the interview—moving around, asking for books and paper, writing, and changing topics. R4 did not make eye contact or stay focused.

LPA reviewed the facility’s notes and found two entries where R4 said staff hit or pushed them. On 12/22/25, R4 said “Jimmy hitting” R4 but no injuries or details were found. On 12/16/25, R4 said “Ann pushed” R4 after coming back from day program, but earlier that day staff had noted on the progress note that R4 was observed picking at an old wound on their hand. Records also showed that on 12/15/25, R4 hurt themselves trying to open the locked drawer, which matches staff statements.

LPA also reviewed R4’s Annual ISP Progress Report (9/1/24–8/31/25) from the day program. The report lists two major behavior concerns: inappropriate touching and making false allegations. The day program documented that R4 often makes statements that are not true, including claims that staff hit R4. These claims were investigated and found to be false. The report shows R4 made, on average, about 3–5 of false allegations per month.

{2 of 3}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 27-AS-20251223090050

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: RICHBOROUGH FOUNTAIN, INC.	FACILITY NUMBER: 347001571
	VISIT DATE: 01/02/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

During LPA’s visit to the facility on 12/24/25, three clients were present with two staff. The clients looked calm, sitting in the living room, and no signs of abuse were seen. One client had acne scars and hand scars that matched what staff had described regarding their behaviors. At the day program, R4 was observed to be easily distracted and constantly moving around.

Based on interviews, record reviews, and observations, there is not enough evidence found to support the allegation that staff hit R4 resulting in injury. R4’s injuries are consistent with staff’s explanation that R4 hurt themselves while attempting to open a locked drawer, and multiple sources confirm that R4 has a documented history of making false allegations. Therefore, the allegation is unsubstantiated.

An unsubstantiated finding 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 did or did not occur.

No deficiencies were found during this visit. Advisories were provided regarding assisting clients with their PRN medications.

An exit interview was completed, and a copy of the report was given.

{3 of 3}

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3