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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700333
Report Date: 12/04/2024
Date Signed: 12/04/2024 03:34:52 PM

Document Has Been Signed on 12/04/2024 03:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
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 INCFACILITY NUMBER:
342700333
ADMINISTRATOR/
DIRECTOR:
SAROAY, PARVEENFACILITY TYPE:
740
ADDRESS:8845 FAIR OAKS BLVDTELEPHONE:
(916) 944-2077
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 106TOTAL ENROLLED CHILDREN: 0CENSUS: 104DATE:
12/04/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Parveen Saroay, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
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On December 4, 2024, Licensing Program Analysts (LPAs) Michael Hood, Angela Hood, and Cassie Mikkelson met with Administrator Parveen Saroay of Fair Oaks Estates Inc, for a case management visit to follow up regarding a substantiated allegation that a resident sexually assaulted other residents in care.

On May 4, 2023, the Department concluded a complaint investigation alleging that a resident (R1) sexually assaulted other residents in care. The allegation was substantiated and the licensee was cited for violating California Code of Regulations (CCR) Title 22, § 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), and California Code of Regulations (CCR) Title 22, § 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.

On May 4, 2023, the issuance of an immediate civil penalty for $500 was issued and Licensee was informed that a civil penalty per Health and Safety Code Section §1569.49(f) is under review and a determination is pending.

The Department has concluded an analysis and has determined that a civil penalty is warranted for physical abuse. Per Welfare and Institutions Code Section 15610.63(e), “’Physical abuse’ means any of the following: (e) Sexual assault, that means any of the following (1) Sexual battery, as defined in Section 243.4 of the Penal Code.” This is evidenced by the facility management being aware of R1’s sexually abusive behaviors towards others and not properly supervising R1, resulting in R1 sexually assaulting four (4) residents.

** Report continued on 809-C **
Anthony PerezTELEPHONE: (323) 485-4915
Michael HoodTELEPHONE: (916) 531-7341
DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 12/04/2024
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An interview with a staff member (S1) indicated that the licensee and administrator were informed of a residents (R1) history of sexually inappropriate behavior before R1's admission to the facility. An interview with R1's responsible party confirmed that this extensive history was disclosed to the administrator prior to placement. Despite awareness of R1’s behaviors, R1 was admitted to the facility without documentation of these behaviors in R1’s Admission Agreement or care plan. Department interviews with staff confirmed that, on November 12, 2022, R1 engaged in sexually inappropriate contact by touching two residents (R2 and R3), on their bare chests. Following this incident, facility staff and the licensee were notified of R1’s need for one-on-one supervision to ensure the safety of other residents. After R1 was taken to the hospital and returned to the facility, an increased level of supervision was added to R1’s care plan. However, R1 continued to move around the facility unsupervised, ultimately resulting in additional incidents where R1 inappropriately touched two more residents (R4 and R5), on December 12, 2022.

Today, December 4, 2024, the Department will be issuing a civil penalty per Health and Safety code § 1569.49 in the amount of $10,000 for a violation that the department determines was caused by the absence of one-on-one supervision as required by statute or regulation, resulting in multiple residents being sexually assaulted. However, since an immediate civil penalty of $500 was issued on May 4, 2023, the amount today will be $9,500.

A copy of the LIC 421D was given to Administrator and originals were signed.

Exit interview conducted. Appeal Rights provided. A copy of the report issued. Signature on this report acknowledges receipt of these rights, found on page 2 of the LIC 421D.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
LIC809 (FAS) - (06/04)
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