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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 345003021
Report Date: 06/17/2026
Date Signed: 06/17/2026 10:38:31 AM

Unfounded


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
06/16/2026 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20260616093524
FACILITY NAME:BLOSSOM RESIDENTIAL 1FACILITY NUMBER:
345003021
ADMINISTRATOR:TRIPADUSH, ALENAFACILITY TYPE:
740
ADDRESS:8934 VAN MOORE LANETELEPHONE:
(916) 578-9821
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:6CENSUS: 6DATE:
06/17/2026
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Administrator, Raluca SolovyevTIME COMPLETED:
10:55 AM
ALLEGATION(S):
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Staff harmed resident in care.
Staff yelled at resident in care.
Staff withheld food from resident in care as a form of punishment.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 6/17/26 to do complaint investigation for above allegations. LPA met with administrator Raluca Solovyev and explained the purpose of the visit.

The department conducted records review ,facility observations and interviews to investigate the complaint.



**Report continued on LIC9099-C**
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2026
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 59-AS-20260616093524
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: BLOSSOM RESIDENTIAL 1
FACILITY NUMBER: 345003021
VISIT DATE: 06/17/2026
NARRATIVE
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**Continued from 9099.....

Allegation- Staff harmed resident in care. Staff yelled at resident in care. UNFOUNDED

The Department conducted interviews with three (3) staff members, four (4) residents and reviewed record regarding the allegations cited above. Residents interviews indicated that staff were providing care and supervision in a professional manner and denied any abuse. Residents stated that no staff were harming or yelling at them and there were no issues to report with this matter. Staff interviews reflected that staff were treating all residents with respect and dignity. Staff stated that they were not aware about any incident where any staff yelled or harm any residents in any manner. Based on this information, these allegations were found to be Unfounded.

Allegation- Staff withheld food from resident in care as a form of punishment. UNFOUNDED



The Department conducted interviews with three (3) staff members, four (4) residents and reviewed record regarding the allegations cited above. Staff interviews indicated that facility was meeting all residents dietary needs per their Needs and Service plan and there were no problems to address. Staff were not aware if any staff withheld any residents food in any manner as form of punishment. Residents interviews reflected that facility was meeting their dietary needs and there were no complaints. No residents interviews indicated any issues regarding any staff were withholding their food in any way. Based on this information, this allegation was found to be Unfounded.

A finding that the allegations are Unfounded means that the allegations are false, could not have happened, and/or is without a reasonable basis.

No citations were issued. Exit interview conducted. A copy of this report has been provided to facility.



SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2