345920108-9-18-2026-59-AS-SCAA-DY2VVS-20260918164648

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 345920108
Report Date: 09/18/2026
Date Signed: 09/18/2026 04:46:59 PM

Document Has Been Signed on 09/18/2026 04:46 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	OAKWOOD MEADOWS ASSISTED LIVING		FACILITY NUMBER:	345920108
ADMINISTRATOR/ DIRECTOR:	TORGERSEN, DANIEL		FACILITY TYPE:	740
ADDRESS:	7241 Canelo Hills DR		TELEPHONE:	(916) 722-2800
CITY:	Citrus Heights	STATE: CA	ZIP CODE:	95610
CAPACITY: 78		CENSUS: 76	DATE:	09/18/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:00 PM
MET WITH:	Kayla Peria, Resident Care Coordinator and Karen Padilla, Director of Nursing		TIME VISIT/ INSPECTION COMPLETED:	04:45 PM

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	Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with Kayla Peria, Resident Care Coordinator (RCC) and Karen Padilla, Director of Nursing (DON), stating the reason for today's inspection. The following (3) incident reports were discussed. Resident (R1) went to the emergency room on September 12, 2026 for having a rash on both arms and legs, which they stated was itchy. (R1) returned the same day with a diagnosis of an allergic reaction, likely due to the antibiotic, Clindamycyn, prescribed on September 9, 2026, for cellulitis on both legs. (R1) returned with (2) new medications- Cetirizine 10 mg and Doxycycline 100mg, twice daily and will be referred for home health services. Staff will assist with elevating (R1's) legs to reduce swelling. (R1) is doing better currently. Resident (R2) wandered into resident (R3's) room on September 14, 2026 (7:00 am), as staff were getting residents ready for breakfast. (R3) scratched (R2) on their face after entering their room and staff immediately responded to screams heard from (R2's) room. Staff applied first aid to (R2's) face which has almost entirely healed. No other injuries were noted. Staff will continue to monitor (R2) and (R3) as well as conduct hourly checks for all residents in the Memory Care Unit (MCU) during the pm and NOC shifts. Staff will also continue to regularly redirect (R2) back to the common area when walking through the MCU. Resident (R4) was sent to the emergency room on September 12, 2026 (1:00 pm) after showing a change in baseline that included refusal of liquid, food and medications. (R4) regularly required assistance with feeding so staff was assisting with meals, drinks and snacks throughout each day. (R4) has been on/off hospice for over 2 years and was last placed on hospice on September 18, 2024 with an admitting diagnosis of a stroke. (R4) has had limited verbal ability but was able to express her needs to staff. (R4) had lower and upper extremity contractures prior to being sent out on September 12, 2026. *report continued on 809C-1..

Lauren Crocker
Sabrina Calzada
	DATE: 09/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: OAKWOOD MEADOWS ASSISTED LIVING	FACILITY NUMBER: 345920108
	VISIT DATE: 09/18/2026

NARRATIVE

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809C-1.. The RCC stated she was the Med-Tech on shift on September 12, 2026 (am) and (R4) was spitting out food and biting on the spoon but had no coughing. (R4) was offered Ensure protein drink but declined. The DON and RCC confirmed (R4) only takes a Calcium supplement and a Multi- vitamin. Both managers also stated that (R4) would regularly drool, when sitting up, prior to being sent out.

The facility was advised by (R4's) responsible person that (R4) suffered a severe stroke on their left side which affected their ability to swallow. (R4) returned to the community on September 14, 2026 under hospice care, and hospice medications have been started. LPA observed the discharge paperwork and only a diagnosis of a stroke (CVA) was noted and no changes in the diet were made.

Both the RCC and DON confirmed that Med-Tech staff have had recent training on signs/symptoms of strokes. A training on this topic will be scheduled to be conducted for caregivers within the next week.

It appears the facility took appropriate and timely action in accessing each resident discussed in the report , and in responding with the appropriate staff intervention, including sending the resident out for further medical evaluation.

There are no deficiencies issued in this report.

Exit interview. Copy of report provided.

NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026

LIC809 (FAS) - (06/04)

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