342700333-11-21-2025-59-AS-MSEY-DNZW56-20251203155836

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700333
Report Date: 11/21/2025
Date Signed: 11/21/2025 03:03:42 PM

Unfounded

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
09/29/2025 and conducted by Evaluator Angela Hood

COMPLAINT CONTROL NUMBER: 59-AS-20250929113251

FACILITY NAME:	FAIR OAKS ESTATES INC		FACILITY NUMBER:	342700333
ADMINISTRATOR:	SAROAY, PARVEEN		FACILITY TYPE:	740
ADDRESS:	8845 FAIR OAKS BLVD		TELEPHONE:	(916) 944-2077
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	121	CENSUS: 109	DATE:	11/21/2025
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Parveen Saroay, Executive Director		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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-Staff are not addressing pests at facility
-Staff did not seek timely medical attention for resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angela Hood arrived at the care home and met with the Executive Director, Parveen Saroay, to deliver complaint investigation findings regarding the above stated allegations. LPA Sabrina Calzada began the investigation and LPA Hood concluded the investigation.

During the course of the investigation, interviews were conducted, observations were made, and documentation pertinent to the investigation was obtained.

According to contract and interviews conducted, the facility has had continuous pest control services. The original contract date for pest control services was signed on August 18, 2023 and was renewed with additional services on February 29, 2024. The pest control treatments are provided monthly to maintain a proactive approach to crawling insects, as well as on an as needed basis per request of the facility.

********************************************Continued on LIC9099-C************************************************

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025

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 3

Control Number 59-AS-20250929113251

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: FAIR OAKS ESTATES INC	FACILITY NUMBER: 342700333
	VISIT DATE: 11/21/2025

NARRATIVE

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On September 25, 2025, resident (R1's) responsible party informed facility staff of their concern regarding bedbugs and cockroaches in R1's room, causing R1 to sustain bug bites. Interview with Maintenance Director (MD) and Resident Care Director (RCD) indicated that, as soon as they were informed of the concern, they removed R1's bed from the room as well as inspected the room for evidence of pests. MD and RCD indicated that they inspected the removed bed and did not observe any evidence of pests. MD and RCD observed R1's room, as well as the roommates belongings and bed, however, did not observe any evidence of pests.

Pest control was contacted and they inspected R1's room on September 30, 2025. According to pest control service summary report, they indicated "after inspection of bed and surrounding area, found no signs of bed bug activity. A few bugs captured in monitors were ext/int roaches. Replaced all glue boards and baited a few areas where roaches are known to traverse. Tech to return next Tuesday for regular scheduled services to gauge overall activity to define next steps". On October 8, 2025, pest control returned due to a callback for concern of bedbugs in R1's room. According to service summary report, "after inspecting unit, I found no signs of bedbugs, no exoskeletons, poop, or egg casings found in bedframe or mattress or along baseboards. Only thing captured in glue boards were 2 roaches, replaced all glue boards and added additional underneath bed to gauge insect activity (if any)".

Interview with Pest Control Technician (PCT) indicated that they provide services every first Tuesday of the month and as needed. PCT indicated that the realistic goal is to keep the pests contained when providing services/treatment. PCT indicated that there is a threshold that they follow when providing services. PCT indicated that the MD also assists by replacing glue boards routinely. PCT indicated that they conducted a full inspection of R1's room with no indication or evidence of bedbugs. PCT indicated that, if there were bedbugs, there would be evidence not only in R1's bed but also in surrounding areas. PCT indicated that infestations do not just spring up. PCT indicated that they cannot bug bomb/fog half or partial of a building and would not risk residents' exposure to fumes due to respiratory issues and other health concerns. PCT indicated that they have other control methods such as gel baits to help control and reduce the population.

On October 9, 2025, LPA Calzada observed R1's room as well as a nearby room with MD and RCD. LPA Calzada did not observe any pests and both rooms were clean.

R1's Progress Notes, dated September 25, 2025, indicated that facility staff observed R1's skin. Staff indicated that there were no signs of bug bites and there was little redness from scratching dry skin. Staff indicated that they faxed R1's Primary Care Physician (PCP) and there was no need to send R1 to the Emergency Department (ER) per responsible party's agreement. Progress Notes also indicated that
*********************************************Continued on LIC9099-C***********************************************

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20250929113251

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: FAIR OAKS ESTATES INC	FACILITY NUMBER: 342700333
	VISIT DATE: 11/21/2025

NARRATIVE

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facility staff attempted to contact R1's PCP daily until they reached them on September 29, 2025. R1's PCP informed facility that, if there is open skin or bites, they need to send R1 to the ER. If not, PCP will be out in a couple days to assess. R1's progress notes indicated that staff were conducting daily skin checks from September 26, 2025-October 16, 2025 and there were no indication of bug bites.

On October 9, 2025, R1 was seen by a physician who indicated that "the head to toe visit revealed no indication of lesions on the body due to bites. Xerosis (dry, flaky skin) and mild lichenification were found along the right arm and bilateral legs. It is recommended to start a daily or twice daily moisturizer that is unscented and gently on the skin". Additionally, the facility had R1's PCP visit them on October 13, 2025 who indicated that the skin issue has completely resolved and to keep on eye on the skin for any new rashes or itching.

According to R1's service plan, the facility implemented applying lotion daily for R1's dry skin on September 25, 2025. Service plan also indicated for staff to continue monitoring R1's skin and report any issues to supervisor.

Based on interviews conducted, documentation reviewed, and observations the above allegations are found to be UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Angela Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025

LIC9099 (FAS) - (06/04)

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