347000008-9-9-2026-59-AS-TORZ-DYLT9A-20261006143138

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347000008
Report Date: 09/09/2026
Date Signed: 09/09/2026 03:23:50 PM

Unsubstantiated

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
07/16/2026 and conducted by Evaluator Kevin Mknelly

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20260716113348

FACILITY NAME:	MERAKI OF SACRAMENTO		FACILITY NUMBER:	347000008
ADMINISTRATOR:	SHAW-CAMACHO, SAMANTHA		FACILITY TYPE:	740
ADDRESS:	4941 TYLER STREET		TELEPHONE:	(916) 348-9316
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95841
CAPACITY:	12	CENSUS: 10	DATE:	09/09/2026
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Samantha Shaw		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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9

Staff are not following medication orders
Due to staff negligence, resident is missing medication

INVESTIGATION FINDINGS:

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On 9/9/26, Licensing Program Analyst (LPA) Kevin Mknelly conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Administrator.

LPA conducted records review and interviews.
LPA is unable to find and or meet the preponderance, per policy.
Records review of centrally stored medication records (CSMR), medication administration records (MAR) and medication orders in R1's file found that medications were administered as ordered. Other records found that R1 has chronic pain with regular communication with health professionals to request medication adjustments. Interviews found R1 to not always recall details of medications.

As a result of this investigation, LPA finds allegation to be (US)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 with administrator and report provided..

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2026

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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