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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342701551
Report Date: 09/10/2026
Date Signed: 09/10/2026 03:38:36 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
09/08/2026 and conducted by Evaluator Kevin Gould
COMPLAINT CONTROL NUMBER: 27-AS-20260908112708
FACILITY NAME:WOODLAKE, THEFACILITY NUMBER:
342701551
ADMINISTRATOR:ROSS, LATRICEFACILITY TYPE:
740
ADDRESS:1445 EXPO PARKWAYTELEPHONE:
(916) 472-5773
CITY:SACRAMENTOSTATE: CAZIP CODE:
95815
CAPACITY:144CENSUS: DATE:
09/10/2026
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Latrice RossTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff are not cleaning resident's cats litter box.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Kevin Gould and Mabel Cummings conducted an unannounced complaint inspection at The Woodlake RCFE on 9/10/26 at 1:30pm to inform the licensee of complaint allegation mentioned above and deliver findings.

Based on the interviews conducted during the investigation process, documentation reviewed and LPA observations, LPAs were unable to corroborate the allegations. LPAs conducted an interview with R1 (see confidential name list LIC-811 dated 9/10/2026). R1 described staff as coming to her residence and cleaning daily. R1 had no complaints or issues regarding staff cleaning her apartment. LPAs did not observe any malodor in the apartment. LPAs did observe the litter box did not have any litter in the box, even though R1 had a large amount of litter containers available. LPAs observed the care tracking sheet for R1, which included pet care instructions and a tracking log for the months of August and September. The log showed consistent staff recording of the pet care. Report continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Arielle Pascua
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
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 27-AS-20260908112708
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: WOODLAKE, THE
FACILITY NUMBER: 342701551
VISIT DATE: 09/10/2026
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. The Department has determined that the allegations of Other are unsubstantiated but if any additional information is received this complaint can be amended and the finding can be changed.

There are no deficiencies is cited per California Code of Regulations, TITLE 22.

Exit interview was conducted with facility staff. Appeal Rights were issued, and a copy of this report was left at the facility.
SUPERVISORS NAME: Arielle Pascua
LICENSING EVALUATOR NAME: Kevin Gould
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2