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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700333
Report Date: 05/04/2023
Date Signed: 05/04/2023 10:11:56 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/07/2022 and conducted by Evaluator Michael Hood
COMPLAINT CONTROL NUMBER: 25-AS-20221207104054
FACILITY NAME:FAIR OAKS ESTATES INCFACILITY NUMBER:
342700333
ADMINISTRATOR:SINGH, GURSHAHBAZFACILITY TYPE:
740
ADDRESS:8845 FAIR OAKS BLVDTELEPHONE:
(916) 944-2077
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:106CENSUS: 100DATE:
05/04/2023
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Parveen Saroay, AdministratorTIME COMPLETED:
10:25 AM
ALLEGATION(S):
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Resident sexually assaulted other residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Parveen Saroay, to deliver findings into the complaint allegation listed above.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

Allegation: Resident sexually assaulted other residents in care

** Report continued on 9099-C **
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
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 3
Control Number 25-AS-20221207104054
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
FACILITY NAME: FAIR OAKS ESTATES INC
FACILITY NUMBER: 342700333
VISIT DATE: 05/04/2023
NARRATIVE
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Interviews with staff conducted be the Department indicated that staff were not fully aware of resident (R1’s) prior sexually inappropriate behavior. However, staff reported and acknowledged R1 had sexually touched several residents (R2, R3, R4, and R5) on their chest or buttocks.

Interview with staff member (S1) indicated that facility management (S2 and Administrator Parveen Saroay) were made aware of R1’s sexually inappropriate past. However, R1 was still admitted into the facility. Interview with relevant party revealed that R1’s extensive sexually inappropriate behavior was disclosed to Administrator Saroay prior to their placement. Despite knowledge of R1’s behavior, R1 was admitted into the facility.

A review of two Sacramento County Sheriff’s Office (SCSO) reports indicated that R2, R3, and R4 reported being touched by R1 in a sexually inappropriate manner. After reported incidents of sexually inappropriate touching at the facility, R1 was sent to the hospital and returned. Upon return, R1 was place on increased supervision.

Despite the changes to R1’s care plan for increased supervision, R1 continued to act sexually inappropriate and touched additional residents (R3 and R4). R1 was also observed to be masturbating and ejaculating in a public part of the facility.

Based on interviews conducted by the Department and records reviewed, the preponderance of evidence standards have been met. Therefore, the above allegations are found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D page. An immediate civil penalty per Health and Safety Code § 1548 in the amount of $500 for the date of 11/30/2022 is assessed for a violation that the department determines was caused by the absence of supervision as required by statute or regulation. An additional civil penalty assessment is under review and a determination is pending. LPA will return on a future date to assess an additional civil penalty if warranted.

Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. Administrator's signature on these forms acknowledges receipt of these documents.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 25-AS-20221207104054
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: FAIR OAKS ESTATES INC
FACILITY NUMBER: 342700333
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/05/2023
Section Cited
CCR
87464(f)(1)
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87464 Basic Services (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not met as evidenced by:
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R1 is no longer a resident at the facility. Administrator will write a plan of how facility staff will protect residents in care when inappropriate sexual behaviors occur. Facility will also conduct an in-service training for all staff regarding care and supervision.
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Based on interviews, reported incidents, and records reviewed, the facility did not ensure that R1 was supervised to prevent further incidents of sexually inappropriate behavior towards other residents in care, which poses an immediate health, safety, and personal rights risk to residents in care.
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Facility will submit to LPA information regarding training, including time and date of training and training material, and written plan by POC due date of 5/5/2023.

An immediate civil penalty of $500 is assessed for a violation caused by the absence of supervision.
Type A
05/05/2023
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement is not met as evidenced by:
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Facility will complete a statement of understanding regarding regulation 87468.1. Facility will submit statement of understanding to LPA by POC due date of 5/5/2023.
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Based on interviews, reported incidents, and records reviewed, the facility did not ensure that residents in care were treated with dignity when R1 sexually inappropriately touched R2, R3, R4, and R5, which poses an immediate health, safety, and personal rights risk to residents in care.
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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: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
LIC9099 (FAS) - (06/04)
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