347001629-4-22-2026-59-AS-TORZ-DTTV8C-20260506161230

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347001629
Report Date: 04/22/2026
Date Signed: 04/22/2026 09:42:50 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
04/01/2026 and conducted by Evaluator Kerry Hiratsuka

COMPLAINT CONTROL NUMBER: 59-AS-20260401130616

FACILITY NAME:	MARIA'S HOME CARE		FACILITY NUMBER:	347001629
ADMINISTRATOR:	ANDREI COSTEA		FACILITY TYPE:	740
ADDRESS:	5914 CANARY DRIVE		TELEPHONE:	(916) 344-5487
CITY:	NORTH HIGHLANDS	STATE: CA	ZIP CODE:	95660
CAPACITY:	6	CENSUS: 5	DATE:	04/22/2026
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Camille McFarlane		TIME COMPLETED:	09:50 AM

ALLEGATION(S):

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Staff physically abuses a resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Hiratsuka, conducted this unannounced complaint visit to deliver the results of the allegation above.

LPA interviewed staff and residents. Based on the above the allegation cannot be determined because each side has their own version of events.

Based on interviews conducted by the Department and records review, the preponderance of evidence standards has not been met. Therefore, the above allegation is found to be UNSUBSTANTIATED. A finding that a complaint allegation 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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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