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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342702896
Report Date: 08/06/2026
Date Signed: 09/04/2026 03:53:45 PM

Substantiated


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
06/04/2026 and conducted by Evaluator Charlie Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260604120822
FACILITY NAME:LEGACY OAKS OF SACRAMENTOFACILITY NUMBER:
342702896
ADMINISTRATOR:DONNABELL GALICIAFACILITY TYPE:
740
ADDRESS:1922 MORSE AVENUETELEPHONE:
(916) 482-7745
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:160CENSUS: 75DATE:
08/06/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Donnabell GaliciaTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Resident eloped due to staff neglect
INVESTIGATION FINDINGS:
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Unannounced complaint visit made out to this facility on 08/06/2026 by Licensing Program Analysts (LPAs) Charlie Yang and Kimberly Kulich who were met by the facility Memory Care Director Tika Chand. A brief interview was conducted with the Memory Care Director at this time.
Current census was 75 residents.
The purpose of this visit was to deliver the findings of this investigation to this facility, and it's representative, at this time.
Based on a review of the forms and documents gathered during the course of this investigation, it was learned that resident R1 was admitted to this facility in the early part of May 2026. It was learned that this resident then left this facility without any staff knowledge or supervision later on in that same month. Upon a review of the resident's file, it was learned that this resident was deemed to be unable to leave this facility unassisted at any given time.
It was learned that this resident left this facility on a weekend and was not returned back to this facility until the following Monday.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
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 4
Control Number 27-AS-20260604120822
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: LEGACY OAKS OF SACRAMENTO
FACILITY NUMBER: 342702896
VISIT DATE: 08/06/2026
NARRATIVE
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Based on interviews conducted during the course of this investigation, it was learned that this facility did not have any policies or procedures put into place to address residents who were deemed to not be able to leave this facility unattended at any given time.
It was learned that these policies and procedures were only put into place after resident R1 eloped from this facility and was returned several days later.
It was learned that even with this determination for R1 to not be able to leave this facility unattended at any given time, facility staff still allowed R1 to leave and return as R1 saw fit. It was learned that there weren't any staffing measures put into place to address individuals who weren't allowed to leave unassisted.

As a result of this investigation, this LPA found the allegation to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegation was valid because the preponderance of the evidence standard had been met.

The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes.

Appeal rights were printed and a copy was left with the facility designated Administrator at this time.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
06/04/2026 and conducted by Evaluator Charlie Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260604120822

FACILITY NAME:LEGACY OAKS OF SACRAMENTOFACILITY NUMBER:
342702896
ADMINISTRATOR:DONNABELL GALICIAFACILITY TYPE:
740
ADDRESS:1922 MORSE AVENUETELEPHONE:
(916) 482-7745
CITY:SACRAMENTOSTATE:CAZIP CODE:
95825
CAPACITY:160CENSUS: 75DATE:
08/06/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Donnabell GaliciaTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff do not ensure resident's hygiene needs are being met
INVESTIGATION FINDINGS:
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Unannounced complaint visit made out to this facility on 08/06/2026 by Licensing Program Analysts (LPAs) Charlie Yang and Kimberly Kulich who were met by the facility Memory Care Director Tika Chand. A brief interview was conducted with the Memory Care Director at this time.
Current census was 75 residents.
The purpose of this visit was to deliver the findings of this investigation to this facility, and it's representative, at this time. Based on a tour of this facility, it was observed that the residents present in the common areas were well groomed at this time. There weren't any odors or signs that residents with incontinence issues were not being met at this time.
A brief tour of the resident bedrooms was conducted. It was observed that they appeared to be maintained in compliance and were able to meet the needs of the residents at this time.
As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegation may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred.
There were no deficiencies observed or cited at this time. Exit Interview
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 27-AS-20260604120822
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: LEGACY OAKS OF SACRAMENTO
FACILITY NUMBER: 342702896
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/07/2026
Section Cited
CCR
87208(a)(11)
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The licensee shall have and maintain a current, written definitive plan of operation for the facility. The licensee shall operate the facility in accordance with the terms specified in the plan of operation and may be cited for not doing so pursuant to Health and Safety Code section 1569.49. The plan and related
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The facility designated Administrator stated that all facility residents will be monitored and redirected to address any wandering or elopement risks at all times.
A statement of correction, along with proof of training in regards to elopement and wandering risks, will be completed and
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materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following:
A description of the ways in which the licensee will address resident behavioral expression as defined in Section 87101, Definitions, including resident assessments, care practices, and safety measures.
This facility was found to be deficient as evidenced by the lack of policies and procedures set forth for staff in dealing with residents who were deemed unable to leave this facility unassisted which posed an immediate threat to the Health, Safety, and Personal Rights to all residents in care.
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submitted into CCL by the due date for review by this LPA.
Proof of training will contain name of vendorized trainer, topic of training, and list of all attendees.
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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: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4