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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347003611
Report Date: 09/25/2024
Date Signed: 09/26/2024 05:09:31 PM

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
06/14/2023 and conducted by Evaluator Christina Valerio
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20230614151545
FACILITY NAME:PRECIOUS ANGELS CAREFACILITY NUMBER:
347003611
ADMINISTRATOR:ALEJO, GLORIAFACILITY TYPE:
740
ADDRESS:8983 RICHBOROUGH WAYTELEPHONE:
(916) 549-2724
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:6CENSUS: 0DATE:
09/25/2024
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Antonette TinTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility may not be financially solvent to continue operating.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
A meeting was held on 9/25/24 at 2:00 PM regarding the findings of an audit report referencing the above mentioned allegation. Present in the meeting was Licensee Antonette Tin, Stephenie Doub, Regional Manager, Stephen Richardson, Licensing Program Manager, Czarrina Camilion-Lee, Licensing Program Manager, Licensing Program Analyst(s) Victoria Brown, Christina Valerio and Kevin Gould. Stephenie Doub stated the purpose of the meeting. Victoria Brown and Stephen Richardson reviewed the findings for the facility.
The Department has determined that a review of the records provided by the licensee and the confirmation by the RO that the facility has no residents in care. Therefore, the auditor has closed this audit request. Based on records review, the allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, the preponderance of evidence standards has not been met. Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies are being cited during this visit. An exit interview was conducted, a copy of this report was provided via email, and an electronic email read receipt confirms receiving these documents.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
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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