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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045002775
Report Date: 09/30/2025
Date Signed: 10/01/2025 09:07:02 AM

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
06/11/2025 and conducted by Evaluator Kayla Adkison
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20250611081310
FACILITY NAME:ROSELEAF GARDENSFACILITY NUMBER:
045002775
ADMINISTRATOR:OWENS, JESSICAFACILITY TYPE:
740
ADDRESS:2770 SIERRA LADERATELEPHONE:
(530) 895-0800
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:56CENSUS: DATE:
09/30/2025
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Jessica Owens, AdministratorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure the air conditioner was working properly
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On September 30, 2025, Licensing Program Analyst (LPA) arrived at the facility unannouced for the purpose of delivering complaint findings. LPA was greeted by Residnetial Care Cooridnator, Amanda Harb, and explained the purpose of the visit. At the time of the visit, there were 26 residents and 3 staff providing care.

Continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kayla Adkison
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
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-20250611081310
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: ROSELEAF GARDENS
FACILITY NUMBER: 045002775
VISIT DATE: 09/30/2025
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
Staff did not ensure the air conditioner was working properly

It was alleged that the facilities air conditioning system had been broken "on the left side of the building" towards "the 100 hall" and the building was noticeably warm. It was reported most residents were moved from their rooms to the other side of the building. It was further alleged a notice had been issued stating the air conditioner would be fixed by June 10, 2025, and no work had been completed by 4:00 PM that day.

On June 11, 2025, LPA Adkison arrived at the facility and met with Administrators Stacey Baxter and Jessica Owen. Administrators informed LPA the broken air conditioners had been replaced that same day. LPA and Administrators toured the facility and made observations. LPA observed 4 (four) air conditioning control panels that read temperatures of 76 degrees F, 76 degrees F, 79 degrees F (left side of building), and 77 degrees F(left side of building). LPA took photos of each panel. Administrator stated the new air conditioners had only been running a couple of hours. LPA noted there were no residents currently living in the halls where the air conditioners were replaced. Administrator confirmed residents were moved to the other side of the building while the facility was waiting for the repair to happen.

LPA reviewed an invoice from Bob's Air Repair dated May 26, 2025, and signed by the Licensee to replace two air conditioning systems. This invoice showed payment was received on June 11, 2025, upon completion of the repair. Additionally, LPA observed cell phone text message screenshots dated June 10, 2025, and June 11, 2025, of conversations between the administrators and licensee discussing the scheduling of the repair to completed.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report was provided to Residential Care Coordinator , Amanda Harb, via email.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kayla Adkison
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
LIC9099 (FAS) - (06/04)
Page: 5 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
06/11/2025 and conducted by Evaluator Kayla Adkison
COMPLAINT CONTROL NUMBER: 59-AS-20250611081310

FACILITY NAME:ROSELEAF GARDENSFACILITY NUMBER:
045002775
ADMINISTRATOR:OWENS, JESSICAFACILITY TYPE:
740
ADDRESS:2770 SIERRA LADERATELEPHONE:
(530) 895-0800
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:56CENSUS: 26DATE:
09/30/2025
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Amanda Harb, residential care coordiantorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure facility van was working properly
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On September 30, 2025, Licensing Program Analyst (LPA) arrived at the facility unannouced for the purpose of delivering complaint findings. LPA was greeted by Residential Care Coordinator, Amanda Harb, and explained the purpose of the visit. At the time of the visit, there were 26 residents and 3 staff providing care.


Continued on LIC 9099-C.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kayla Adkison
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 59-AS-20250611081310
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: ROSELEAF GARDENS
FACILITY NUMBER: 045002775
VISIT DATE: 09/30/2025
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
Staff did not ensure facility van was working properly

It was alleged the facility's resident transportation van was not in working order.

On June 11, 2025, LPA Adkison observed the facility's van to have a dead battery and was not operable. Administrator stated the vehicle is rarely ever used and resident's are transported by family member's to appointments, errands, etc. Administrator further stated that there is an additional vehicle that can be used for resident transportation located at the sister facility Roseleaf Oroville located in Oroville, CA.

LPA reviewed the facility's Admission Agreement. On Page 7, Section G, titled "Transportation", the agreement states " We (Roseleaf Gardens) will make available to residents, or otherwise assure the provision of, scheduled transportation to the nearest appropriate health facilities for medical and dental appointments..."

Based on observations, interviews, and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, (Title 22), is cited on the attached LIC 9099D. Exit Interview conducted. A copy of this report and Appeal Rights were provided to Residential Care Coordinator, Amanda Harb..
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kayla Adkison
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 59-AS-20250611081310
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: ROSELEAF GARDENS
FACILITY NUMBER: 045002775
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/10/2025
Section Cited
CCR
87312
1
2
3
4
5
6
7
87312 Motor Vehicles Used in Transporting Residents
....Any vehicle used by the facility to transport residents shall be maintained in a safe operating condition. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee/Administrator agrees to ensure the vehicle is in working order by end of business on October 10, 2025. LIcensee/Administrator shall provide proof of purchase for any parts needed and any addiitonal work done on the vehicle to LPA via email by this date.
8
9
10
11
12
13
14
Based on observation, interviews, and records reviewed, the licensee did not ensure that the facility transportation vehicle was in working order which poses a potential health, safety or personal rights violation.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kayla Adkison
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5