<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347005161
Report Date: 09/23/2026
Date Signed: 09/23/2026 01:22:01 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
04/30/2026 and conducted by Evaluator Angela Hood
COMPLAINT CONTROL NUMBER: 59-AS-20260430152743
FACILITY NAME:A & C CARE HOME #2FACILITY NUMBER:
347005161
ADMINISTRATOR:SUAYBAGUIO, CECILIAFACILITY TYPE:
740
ADDRESS:3601 GARFIELD AVE.TELEPHONE:
(916) 993-8755
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 2DATE:
09/23/2026
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Cecilia Suaybaguio, AdministratorTIME COMPLETED:
01:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Staff did not address pressure injury that resident developed
-Staff are not providing resident with adequate care and supervision
-Staff handle resident in a rough manner
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Angela Hood arrived at the care home today and met with the Administrator, Cecila Suaybaguio, to deliver complaint investigation findings regarding the above stated allegations.

During the course of the investigation, LPA conducted interviews, obtained documentation, and requested additional documentation pertinent to the investigation.

According to resident (R1’s) Admission Agreement, R1 was admitted to the care home on March 4, 2026. R1’s Medical Assessment LIC602A, dated March 3, 2026, indicated that R1 was non-ambulatory and did not require assistance with repositioning and transferring. The LIC602A did not have any indication of R1 having pressure injuries. According to R1’s Transfer/Discharge Report from the skilled nursing facility, dated March 3, 2026, R1 had an impaired skin condition, however, did not have any wounds present. Transfer/Discharge Report indicated that R1 had pitting edema on their right and left feet, fluid retention, left lateral skin tear,
***************************************************Continued on LIC9099-C*************************************************
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
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-20260430152743
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: A & C CARE HOME #2
FACILITY NUMBER: 347005161
VISIT DATE: 09/23/2026
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
middle upper back skin tear, nonpitting edema to left upper extremity, and swelling of the left knee. Interview with R1’s responsible party indicated that R1 had a little sore on their “backside”, however, the facility got another bed to relieve pressure and, after the new bed, everything was ok. Interview with R1’s nurse practitioner (NP) indicated that R1 developed a pressure wound on or about April 10, 2026 and began home health services on April 14, 2026, due to the pressure wound. Interview with NP indicated that R1 had a stage 2 wound on their sacrum that was observed during a mobile visit with R1 on April 10, 2026. The facility had informed them that R1 had redness on their bottom and that they needed more cream. Interview with NP also indicated that an order was placed on April 7, 2026 for an alternating pressure mattress for R1. Interview with relevant party indicated that, on March 2, 2026, R1’s primary care physician (PCP) had sent an order for home health services with medication and rehabilitation. Relevant party indicated that on April 20, 2026, April 22, 2026, April 24, 2026, April 27, 2026, April 29, 2026, and May 1, 2026, R1 received home health visits. Relevant party indicated that, on April 28, 2026, R1 had wound care for their upper back, which previously was provided for their lower back. Relevant party indicated that they were unable to provide clarification regarding home health or palliative care notes and would prefer a medical staff to discuss documentation. Interview with NP also provided some unclear dates of service. LPA requested home health records on August 10, 2026, which included intake documentation, assessments, progress notes, and any documentation for the assessment conducted for the palliative care visit. LPA followed up regarding request on August 14, 2026 and August 21, 2026 via email and left voice messages. To date, LPA has not received the records requested.

Interview with R1’s responsible party and Administrator indicated that R1’s responsible party was at the care home everyday to visit R1. Interview with R1’s responsible party indicated that they felt the facility staff were doing a really good job with care and supervision. R1’s responsible party indicated that staff were checking on R1 throughout the day, changing R1’s diaper, and asking if R1 needed anything even when they were visiting. R1’s responsible party indicated that they would visit during different times everyday and there were always at least two (2) staff present and that the owner would be there everyday or every other day as well. R1’s responsible party indicated that they would have taken care of the situation right away if they noticed anything wrong. They had no concerns regarding care and supervision. Interview with the Administrator indicated that they would work the NOC shift and stay with R1 all night, due to R1 wanting staff with them all night. Administrator indicated that R1 was checked every 2 hours and had a bell in their room to notify staff
************************************************Continued on LIC9099-C**************************************************
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 59-AS-20260430152743
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: A & C CARE HOME #2
FACILITY NUMBER: 347005161
VISIT DATE: 09/23/2026
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
if they wanted assistance. Administrator indicated that R1 also had a loud voice so staff could hear them if they needed anything. Administrator indicated that R1 would not want to sit at the table, so their food was provided to them in their room. Interview with staff (S1) indicated that they would change R1 every morning and at lunchtime, as well as when needed. S1 indicated that they could hear R1 when they needed assistance. S1 indicated that they would take R1 their food in their room and sit with them. S1 indicated that R1 always had water on the tray in front of them and were provided other drinks if they wanted. Interview with resident (R2) indicated that they receive assistance and good care. R2 stated that they prefer eating in their room and that they always have water or a drink. R2 stated that they are frequently changed for incontinence. Interview with resident (R3) indicated that they eat in their room and staff bring them water or drinks. R3 indicated that staff change their diaper frequently and they have no issues with being wet or dirty. R3 indicated that staff check on them frequently. Interview with resident (R4) indicated that they eat at the dining table and always have a drink or water. R4 indicated that staff provide assistance with incontinence and are providing great care. R2, R3, and R4 had no concerns regarding care or supervision at the care home.

Interview with R1’s responsible party, the Administrator, and Licensee at the new facility R1 resides at indicated that R1 has low pain tolerance and pain sensitivity when touched. Interview with Administrator and S1 indicated that two (2) staff would assist R1 to ensure they are not hurting R1 due to their pain intolerance. R1’s responsible party indicated that R1 was definitely not being abused, and they never observed any bruising on R1. Interview with the Licensee at the new facility R1 resides at indicated that they did not observe any bruising when conducting the assessment of R1 or upon move into their facility. R1’s nurse practitioner indicated that there was no bruising observed during their visits with R1. Interviews with R2 and R4 indicated that staff are not too rough when providing assistance. Interview with R3 indicated that transferring is ok with staff and that they are not too rough. R2, R3, and R4 indicated that staff treat them well and that they have no concerns.

Based on interviews conducted and documentation obtained, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are UNSUBSTANTIATED. No deficiencies are being cited.
Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC9099 (FAS) - (06/04)
Page: 3 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
04/30/2026 and conducted by Evaluator Angela Hood
COMPLAINT CONTROL NUMBER: 59-AS-20260430152743

FACILITY NAME:A & C CARE HOME #2FACILITY NUMBER:
347005161
ADMINISTRATOR:SUAYBAGUIO, CECILIAFACILITY TYPE:
740
ADDRESS:3601 GARFIELD AVE.TELEPHONE:
(916) 993-8755
CITY:CARMICHAELSTATE:CAZIP CODE:
95608
CAPACITY:6CENSUS: 2DATE:
09/23/2026
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Cecilia Suaybaguio, AdministratorTIME COMPLETED:
01:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Unlawful eviction
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Angela Hood arrived at the care home today and met with the Administrator, Cecilia Suaybaguio, to deliver complaint investigation findings regarding the above stated allegation.

During the course of the investigation, LPA conducted interviews and obtained documentation pertinent to the investigation.


**********************************************Continued on LIC9099-C***************************************************
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
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-20260430152743
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: A & C CARE HOME #2
FACILITY NUMBER: 347005161
VISIT DATE: 09/23/2026
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
Interview with resident (R1’s) responsible party indicated that R1 was not evicted from the care home. R1’s responsible party indicated that they spoke with the Administrator and agreed that it might be best for R1 to move to a different facility. R1’s responsible party indicated that it was R1’s clinical services company that initiated the move and took care of everything. Interview with R1’s nurse practitioner indicated that R1 moved out of the care home on May 1, 2026. Interview with Administrator indicated that they did not evict R1 from the care home and never stated that R1 had to leave. The Administrator indicated that they spoke with R1’s responsible party regarding R1’s care needs and then R1’s clinical services company contacted them indicating that they had a place for R1 to move. According to Administrator, R1 moved out of the care home on May 1, 2026.

Based on interviews conducted, the above allegation is found to be UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. No deficiencies are being cited. Exit interview conducted. A copy of report was provided.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5