347005096-2-14-2025-27-AS-CACL-DE323U-20250219160254

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347005096
Report Date: 02/14/2025
Date Signed: 02/14/2025 10:08:14 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
09/26/2024 and conducted by Evaluator Kevin Gould

COMPLAINT CONTROL NUMBER: 27-AS-20240926101825

FACILITY NAME:	WAVECREST VILLA, RCFE		FACILITY NUMBER:	347005096
ADMINISTRATOR:	ENERO, CHRISTINE		FACILITY TYPE:	740
ADDRESS:	7005 WAVECREST WAY		TELEPHONE:	(916) 346-4770
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95831
CAPACITY:	6	CENSUS: 6	DATE:	02/14/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Mimi Matabilas		TIME COMPLETED:	10:20 AM

ALLEGATION(S):

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The facility is not financially solvent

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Kevin Gould made an unannounced inspection to Wavecrest Villa RCFE on 2/14/25 at 9:30am to conclude the investigation of the above allegation and to deliver the findings. LPA Gould met with staff, Mimi Matabilas and together discussed the investigation details.

Based on the documentation obtained during the investigation process, LPA Gould was unable to corroborate the allegations. LPA requested and reviewed three months of utility bills including electricity, water and gas. LPA observed the facility is current with all utilities bills and observed a zero balance at the end of each month for all bills requested and reviewed. LPA conducted a tour of the home and observed the facility is well staffed to meet the needs of residents and is operating the facility in compliance with title 22 regulations. LPA observed plentiful food supplies for residents. The home is clean and in good repair.

Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 214-5136
LICENSING EVALUATOR NAME: Kevin Gould	TELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025

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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Control Number 27-AS-20240926101825

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: WAVECREST VILLA, RCFE	FACILITY NUMBER: 347005096
	VISIT DATE: 02/14/2025

NARRATIVE

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Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of Financial Issues are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed.

There are no deficiencies is cited per California Code of Regulations, TITLE 22.

Exit interview was conducted with facility staff. Appeal Rights were issued, and a copy of this report was left at the facility.

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 214-5136
LICENSING EVALUATOR NAME: Kevin Gould	TELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025

LIC9099 (FAS) - (06/04)

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