315920340-9-16-2026-59-AS-TORZ-DYLTDS-20261006143851

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 315920340
Report Date: 09/16/2026
Date Signed: 09/16/2026 09:28:08 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/04/2026 and conducted by Evaluator Bethany Mirlohi

COMPLAINT CONTROL NUMBER: 59-AS-20260904084140

FACILITY NAME:	RAI ANGELS 2		FACILITY NUMBER:	315920340
ADMINISTRATOR:	RAI, BALWINDER		FACILITY TYPE:	740
ADDRESS:	1422 ORWELL DR		TELEPHONE:	(916) 945-2122
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY:	6	CENSUS: 5	DATE:	09/16/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Balwinder Rai, Administrator		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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Staff did not ensure resident's authorized representative received a refund

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to deliver complaint findings. LPA spoke to Administrator Balwinder Rai during today's inspection.

LPA investigated allegation, "Staff did not ensure resident's authorized representative received a refund". Initially relevant party reported that licensee did not refund responsible party once R1 passed away on hospice. LPA interviewed responsible party and they stated they have received the refund from licensee. Licensee provided LPA a copy of the check and documentation showing the check was cashed. Due to the information gathered, LPA finds allegation to be UNFOUNDED.

Exit interview conducted and copy of report provided.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2026

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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