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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 317000237
Report Date: 02/27/2025
Date Signed: 02/27/2025 10:26:16 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
02/07/2025 and conducted by Evaluator Cassandra Mikkelson
COMPLAINT CONTROL NUMBER: 59-AS-20250207144045
FACILITY NAME:OAKWOOD VILLAGE, INC.FACILITY NUMBER:
317000237
ADMINISTRATOR:UCLARAY, PATTYFACILITY TYPE:
740
ADDRESS:3388 BELL ROADTELEPHONE:
(530) 889-8122
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:124CENSUS: 53DATE:
02/27/2025
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Patty Uclaray, AdministratorTIME COMPLETED:
10:35 AM
ALLEGATION(S):
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Staff did not follow residents care plan
Staff did not ensure the bed/chair alarms were in working order
Staff did not ensure residents personal hygine needs were met
INVESTIGATION FINDINGS:
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Licensed Program Analyst (LPA) Cassandra Mikkelson arrived at the facility unannounced and met with Administrator Patty Uclaray to deliver findings for the above complaint allegations.

During the investigation, LPA conducted interviews, conducted a tour of the facility, and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

***Report continued on 9099-C***
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 709-6317
LICENSING EVALUATOR NAME: Cassandra MikkelsonTELEPHONE: (916) 709-6830
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025
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 2
Control Number 59-AS-20250207144045
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: OAKWOOD VILLAGE, INC.
FACILITY NUMBER: 317000237
VISIT DATE: 02/27/2025
NARRATIVE
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Interviews with Residents R1, R2, R3, and R4 indicated that each were happy with the care they have been receiving at the facility from all care staff. R1, R2, R3, and R4 all use call buttons either worn as a bracelet or a necklace. Each indicated that when they push their call button for help, care staff arrive promptly to assist. R2, R3 and R4 stated that they receive help with showers each week. R2, R3 and R4 have not had any issues receiving showers by staff or changing shower days based on what is convenient for them. R1 is able to shower independently but feels comfortable asking for help from staff when needed.

Interview with Administrator Patty Uclaray indicated that residents must have a signed consent form that authorizes the use of call buttons or bed/chair alarms as it is not a requirement by the facility that each resident wear a call button. Administrator Uclaray stated that the facility is actively hiring more staff to decrease call button response times by staff and improve overall resident care and supervision. Administrator stated that each resident has their own care plan which coincides with their current LIC602/ physician’s report and is updated yearly or when a resident had a change in condition.

During the investigation, LPA toured the facility with Administrator Patty Uclaray. LPA observed resident rooms and hallways to be in clean and sanitary condition with no odors. LPA did not observe any residents to be in poor hygiene. Through interviews conducted and documents reviewed, LPA determined that staff are assisting residents meet their hygiene needs.

Based on interviews conducted, observations, and records reviewed, the preponderance of evidence standards have not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. Findings that the complaint is Unsubstantiated means that, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview was conducted with Patty Uclaray. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.

SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 709-6317
LICENSING EVALUATOR NAME: Cassandra MikkelsonTELEPHONE: (916) 709-6830
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2