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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502700653
Report Date: 01/23/2026
Date Signed: 01/23/2026 10:59:18 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
01/07/2026 and conducted by Evaluator Jason Lund
COMPLAINT CONTROL NUMBER: 27-AS-20260107090433
FACILITY NAME:SUNSHINE RESIDENTIAL IIIFACILITY NUMBER:
502700653
ADMINISTRATOR:AMOAH, MARYFACILITY TYPE:
735
ADDRESS:1233 FAWN LILY DRIVETELEPHONE:
(510) 935-8503
CITY:PATTERSONSTATE: CAZIP CODE:
95363
CAPACITY:6CENSUS: 1DATE:
01/23/2026
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Care Staff Princess MercadoTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not properly store client's medication
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jason Lund arrived unannounced to open and a complaint investigation. LPA Lund met with Administrator Mary Amoah and explained the reason for the visit.

Staff did not ensure resident's medication was centrally stored and inaccessible to residents in care - LPA Lund interviewed RP, Staff, and Administrator Mary Amoah. It was observed on 12/8/2025 that Client (C1) medication was in the refrigerator but and not locked in the medication lock box during a visit. C1 medication needs a needle to inject the medication. The medication was not assessable do to the needles being stored in a locked cabenet.

Based on interviews with RP, Staff and Administrator Mary Amoah , the information provided, it clear that staff did not ensure resident's medication was centrally stored and accessible to residents, but the needles not being accessible to clients in care therefore the allegation was deemed UNSUBSTANTIATED.

Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026
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 2
Control Number 27-AS-20260107090433
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: SUNSHINE RESIDENTIAL III
FACILITY NUMBER: 502700653
VISIT DATE: 01/23/2026
NARRATIVE
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As a result of this investigation, this Department finds the allegation to be UNSUBSTANTIATED. A complaint allegation finding of 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 conducted and report left.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2