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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 317000237
Report Date: 10/10/2024
Date Signed: 10/10/2024 03:41:18 PM

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
07/22/2024 and conducted by Evaluator Kerry Hiratsuka
COMPLAINT CONTROL NUMBER: 59-AS-20240722102908
FACILITY NAME:OAKWOOD VILLAGE, INC.FACILITY NUMBER:
317000237
ADMINISTRATOR:CATHY DUSTINFACILITY TYPE:
740
ADDRESS:3388 BELL ROADTELEPHONE:
(530) 889-8122
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:124CENSUS: 39DATE:
10/10/2024
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Patty UclcrayTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff not checking on residents leaving residents in soiled briefs for many hours
INVESTIGATION FINDINGS:
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LPA Hiratsuka conducted the investigation into the allegation above,
LPA Hiratsuka interviewed staff and reviewed resident records. Interviews stated some residents have been left in soiled briefs for an undermined amount of time and some interviews stated residents have not. Some interviews state residents cannot be put on set schedules of when they need to urinate or defecate because residents do not have control of when they need to do those bodily functions. Residents who have heavier incontinence have been noted in their charts and are supposed to be checked more frequently. Some staff stated the residents are and some stated the residents are not. Some staff stated the residents are supposed to be changed prior to shift change and are not being changed. LPA unable to interview residents in question due to mental capacity.
Based on the above, LPA cannot prove or disprove because each side has their own version of events.
Due to the information gathered, LPA cannot determine the allegation: Staff not checking on residents leaving residents in soiled briefs for many hours. LPA finds allegation to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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