345920306-9-2-2026-59-AS-LCRR-DYCQ2F-20260928114703

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 345920306
Report Date: 09/02/2026
Date Signed: 09/02/2026 12:43:13 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
06/26/2026 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20260626094013

FACILITY NAME:	MOM & POPS LOVING NEST		FACILITY NUMBER:	345920306
ADMINISTRATOR:	MIHAI, CLAUDIA		FACILITY TYPE:	740
ADDRESS:	7800 CLAYPOOL WAY		TELEPHONE:	(916) 910-9779
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	6	CENSUS: 6	DATE:	09/02/2026
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Claudia Mihai, Administrator		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not provide a refund upon resident’s death.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver findings to a complaint received on June 26, 2026. Also present were staff, Nanalie Bodden and Evelyn Bodden, who assists with cooking. LPA met with Administrator, Claudia Mihai, who arrived around 12:00 pm. LPA stated the reason for the inspection. There is (1) resident currently under hospice care.

During the investigation, LPA interviewed the Administrator, (2) staff, and the responsible person for resident (R1). LPA reviewed documentation related to (R1), including their physician's report, admission agreement, email and text communications between the Administrator and the responsible person, and attempted calls to the responsible person by the Administrator. The results of the investigation are as follows:

Resident (R1) moved to the community on/around February 17, 2025. (R1) had a diagnosis of Coronary Artery Disease, Diabetes, Parkinson's Dementia and needed assistance with transferring (2-person), bathing, toileting, medications but was able to feed independently. (R1) was placed on hospice on/around March 2025, and passed on June 5, 2026.
*cont on 9099C-1..

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026

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 5

Control Number 59-AS-20260626094013

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MOM & POPS LOVING NEST	FACILITY NUMBER: 345920306
	VISIT DATE: 09/02/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

9099C-1.. Allegation: Staff did not provide a refund upon resident’s death. The allegation states
(R1) passed on June 5, 2026, their belongings were removed from the facility on June 7, 2026, but the refund due for the remainder of the month has not been paid back.

The responsible person for (R1) stated requests were made to the facility that a refund be issued for the remaining balance for June 2026, after (R1's) belongings were removed from their room on June 7, 2026, but she has not received payment as of June 26, 2026.

The Administrator stated she tried to reach out to (R1's) responsible person on 6/6/26 and on 6/8/26, and showed LPA the text messages. LPA could see there were no text responses sent back to the Administrator.
The Administrator also showed LPA how she attempted to contact (R1's) responsible person by phone on June 4, 2026, June 5, 2026, June 6, 2026, June 8, 2026 and again on June 12, 2026. The calls ranged in length from 6 seconds to 9 minutes. The Administrator stated she left a voice mail at least 1-2 times, asking the responsible person to "please call so we can discuss the refund".

The signed Admission Agreement states under Termination of the Agreement- The agreement will automatically be terminated by the death of the resident. The resident's relatives and/or responsible person will not be liable for any payment beyond that due at the date of death.

A refund was due to be issued within (15) days of the belongings being removed, or by June 22, 2026. A refund was issued on July 3, 2026, for (23) days pre-paid rent for June 2026, following when the belongings were removed.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following (1) deficiency is issued on the 9099-D page.

Exit interview. Copy of report and appeal rights provided.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 59-AS-20260626094013

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MOM & POPS LOVING NEST	FACILITY NUMBER: 345920306
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/02/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/16/2026 Section Cited HSC 1569.652(c)	1 2 3 4 5 6 7	§1569.652 Termination of admission agreement upon death of resident; removal of resident’s property; refund of fees paid; notice of contract termination and refunds. (c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee/Administrator issued a refund by check, on July 3, 2026, to (R1's) responsible person for (23) days of pre-paid rent in June 2026.
	8 9 10 11 12 13 14	Based on interviews conducted, text messages and documentation reviewed, the Licensee did not ensure that a refund was issued timely, by June 22, 2026, for the (23) days remaining in June 2026, following when (R1's) belongings were removed from their room on June 7, 2026, which posed a potential health and safety risk and/or personal rights violation to residents in care.	8 9 10 11 12 13 14	Admin agrees to read/sign a statement that HSC 1569.652 is understood. Also, that payment must be made by mail if no contact can be made with the responsible person to pick up the refund in person. Documentation due by September 16, 2026 to CCLD.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
06/26/2026 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20260626094013

FACILITY NAME:	MOM & POPS LOVING NEST		FACILITY NUMBER:	345920306
ADMINISTRATOR:	MIHAI, CLAUDIA		FACILITY TYPE:	740
ADDRESS:	7800 CLAYPOOL WAY		TELEPHONE:	(916) 910-9779
CITY:	CITRUS HEIGHTS	STATE:CA	ZIP CODE:	95610
CAPACITY:	6	CENSUS:	DATE:	09/02/2026
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Claudia Mihai, Administrator		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not safeguard resident's jewelry.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

During the investigation, LPA interviewed the Administrator, (2) staff, the responsible person for resident (R1), and (2) other individuals who knew (R1). LPA attempted to speak to a hospice nurse but was not able to. LPA reviewed documentation related to (R1), including their physician's report, admission agreement, emails from the responsible person to the Department, and a photo provided of (R1) wearing a ring.

The results of the investigation are as follows:

Allegation: Staff did not safeguard resident's jewelry. The allegation states that (R1) moved in to the facility with a wedding ring and it went missing one month prior to their passing on June 5, 2026.

*cont on 9099A-C-1...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 59-AS-20260626094013

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MOM & POPS LOVING NEST	FACILITY NUMBER: 345920306
	VISIT DATE: 09/02/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

9099A-C-1.. The responsible person stated she was told by a caregiver that (R1) "no longer has the ring" and "it must have gotten lost in the laundry", but could not recall the name of the staff. This person stated (R1) had the ring from "February 2025 through May 6, 2026" and "never took it off".

The Administrator stated (R1) did not move in with a ring, and she doesn't allow residents to move in with valuable jewelry unless they are cognitively capable of safeguarding it. The form "Client/Resident Personal Property and Valuables" (LIC621) does not list any property.

Two other individuals were interviewed who knew (R1) for an extended period of time. One individual stated (R1) "never wore a ring", and (R1) "had multiple rings"; however, she was not familiar with a ring made up of three different golds".

A second individual stated that (R1) had a lot of real jewelry" but was "not sure" if (R1) had the ring when they went to the facility.

Two (2) staff were interviewed who worked at the facility when (R1) resided there. Both staff stated they recalled (R1) but didn't "recall (R1) wearing a ring." and did not state that (R1's) ring "must have gotten lost in the laundry", as the responsible person "never mentioned a ring" . Both staff stated they help with laundry.

LPA was not able to speak to a hospice nurse regarding if a ring was observed on (R1) at any time during their visits. The Department was provided with a photo of (R1) wearing a ring on their 4th finger, left hand. The responsible person stated in an email that the photo was taken on June 20, 2025, but then also said the ring disappeared about a month before (R1's) passing on June 5, 2026.

Based on information obtained, the allegation is found to be UNSUBSTANTIATED- 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. Copy of report provided.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026

LIC9099 (FAS) - (06/04)

Page: 5 of 5