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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701111
Report Date: 08/04/2026
Date Signed: 08/05/2026 01:02:23 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
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:
08/04/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:YOUNGSUK CHOTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
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8
9
Staff are not ensuring residents meal times are appropriately spaced to meet the needs of resident
Staff did not allow authorized representative to bring outside food to resident
Staff do not allow residents to drink after 3 PM
Staff make residents stay in their room
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 08/04/26, 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.

During the visit LPA requested and reviewed the follwoing documention: most recent LIC 500, LIC 9020 and Sample menu.

Staff are not ensuring residents meal times are appropriately spaced to meet the needs of resident, based on observations, interviews, and records reviewed, the facility meal schedule was reviewed and meals were observed being provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
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 4
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:
08/04/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:YOUNGSUK CHOTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not providing snacks to residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 08/04/26, 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, Joyce S Mabunga was called and joined 10 minutes later and LPA stated the purpose of the visit.

During the visit LPA requested and reviewed the follwoing documention: most recent LIC 500, LIC 9020 and Sample menu.

Staff are not providing snacks to residents, based on LPA observations, interviews conducted, and records reviewed, it was determined that residents were not routinely provided snacks. During the May 2026 visit, staff reported snacks were not routinely provided, and LPA did not observe snacks being offered. During todays visit, snacks were not offered during the schedued time as stated in the sample menu.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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: 08/04/2026
NARRATIVE
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Based on interviews, records reviewed and observations, it was determined that residents were not routinely provided snacks as stated in the sample menu. Therefore, the above allegation is found to be Substantiated.

Based on interviews, record review and observations, the allegations are substantiated.

The preponderance of evidence standard has been met, therefore, the allegation is SUBSTANTIATED.

Exit interview was conducted and a copy of the report was given the acting administrator, Youngsuk Cho. No citations were issued per Title 22 regulations.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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: 08/04/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
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25
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27
28
29
30
31
32
Staff did not allow authorized representative to bring outside food to resident, based on interviews conducted, the facility permits family members to bring outside food for residents.

Staff do not allow residents to drink after 3 PM, interviews, and records reviewed, staff reported that water is offered with meals and between meals as needed. During the visit, LPA did not observe residents being denied fluids.



Staff make residents stay in their room based on LPA observations and interviews conducted resident (R1) were observed in the common areas of the facility. LPA did not observe staff restricting residents to their rooms or preventing residents from leaving their rooms.

Based on interviews, record review and observations, the allegations are unsubstantiated.



Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations occurred, therefore, the allegations are UNSUBSTANTIATED.

Exit interview was conducted and a copy of the report was given the acting administrator, Youngsuk ChoNo citations were issued per Title 22 regulations.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Melina Oropeza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4