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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701111
Report Date: 08/18/2026
Date Signed: 08/18/2026 11:05:40 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
05/18/2026 and conducted by Evaluator Melina Oropeza
COMPLAINT CONTROL NUMBER: 27-AS-20260518111947
FACILITY NAME:AN ANGEL GARDEN INCFACILITY NUMBER:
342701111
ADMINISTRATOR:CHO, YOUNGSUKFACILITY TYPE:
740
ADDRESS:9873 TRAVELER COURTTELEPHONE:
(530) 886-9529
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:6CENSUS: 2DATE:
08/18/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:YOUNGSUK CHOTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff are not administering residents medication as prescribed
Staff did not notice residents change in condition resulting in hospitaliization
Staff did not ensure resident was eating meals in quantity resulting in 20lb weight loss
INVESTIGATION FINDINGS:
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On 08/18/26, Licensing Program Analyst (LPA) Melina Oropeza made an unannounced visit to this facility to continue a complaint investigation for the above allegations. LPA identified themselves upon arrival, stated the purpose of their vist to staff. Administrator, Youngsuk Cho was called and joined 10 minutes later and LPA stated the purpose of the visit.

Staff are not administering resident’s medication as prescribed based on the Department reviewed records and R1’s medical records. The records reviewed did not support that medication mismanagement resulted in R1’s hospitalization or bodily harm. Therefore, the allegation is UNSUBSTANTIATED.

Staff did not notice resident’s change in condition resulting in hospitalization based on the Department reviewed records and R1’s medical records. Records indicated facility staff observed a change in R1’s condition and sent R1 for medical evaluation. Therefore, the allegation is UNSUBSTANTIATED.

Staff did not ensure resident was eating meals in quantity resulting in 20-lb weight lose based on the Department reviewed records and R1’s medical records. The records reviewed did not support that R1 experienced the alleged significant weight loss. Therefore, the allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
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-20260518111947
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: AN ANGEL GARDEN INC
FACILITY NUMBER: 342701111
VISIT DATE: 08/18/2026
NARRATIVE
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A finding that the complaint 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.

Exit interview was conducted and a copy of the report was given the acting administrator, Youngsuk Cho. No citations were not issued per Title 22 regulations.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2