342700873-12-9-2025-59-AS-LCRR-DPQQS7-20251226112504

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700873
Report Date: 12/09/2025
Date Signed: 12/09/2025 02:32:54 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
11/26/2025 and conducted by Evaluator Michael Hood

COMPLAINT CONTROL NUMBER: 59-AS-20251126113848

FACILITY NAME:	MEADOWOOD HOME, LLC		FACILITY NUMBER:	342700873
ADMINISTRATOR:	ASTORGA, ANTONIETTE		FACILITY TYPE:	734
ADDRESS:	4701 MEADOWOOD WAY		TELEPHONE:	(916) 662-5684
CITY:	FAIR OAKS	STATE: CA	ZIP CODE:	95628
CAPACITY:	5	CENSUS: 5	DATE:	12/09/2025
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Antoniette Astorga, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff did not ensure that resident's dental care needs are met

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Antoniette Astorga, to deliver findings into the complaint allegation listed above.

During the investigation, LPA conducted interviews and reviewed documentation pertinent to the investigation. The results of the investigation are as follows:

Allegation: Staff did not ensure that resident's dental care needs are met

Interview with Administrator indicated that resident (R1) was seen by a hygienist on August 9, 2025, who referred R1 for sedation dentistry. Administrator stated that there is only one (1) dentist in the Sacramento area who provides sedation dentistry services.

** Report continued on 9099-C **

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025

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 4

Control Number 59-AS-20251126113848

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: MEADOWOOD HOME, LLC	FACILITY NUMBER: 342700873
	VISIT DATE: 12/09/2025

NARRATIVE

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Administrator stated that they attempted to reach out to dentist sometime in August 2025 and sometime in September 2025 to see if dentist would take R1. Administrator stated that they were informed that dentist was not taking any new clients and, if they were to take R1 as a client, R1 would have to be placed on a waitlist that lasted at least one (1) year. Upon opening the complaint on December 1, 2025, R1 had yet to be placed on a waitlist for sedation dentistry. Administrator stated that R1 would require sedation for dental work as they will clamp down and bite. Administrator stated that they reached out to Alta California Regional Center (ACRC) who has a dental coordinator to assist with arranging dental services for R1.

LPA interviewed ACRC representative, who stated that they started working with R1 late July, 2025. ACRC representative stated that they spoke with a dental coordinator with ACRC and was informed that R1's Power of Attorney (POA) would need to reach out to Health Net to request services for sedation dentistry. ACRC representative stated that facility usually takes care of arranging dental services for clients. ACRC representative stated that facility was attempting to find dental services for R1 but was unsuccessful. ACRC representative stated that Health Net could assist with arranging dental for R1, but would need to be contacted by R1's authorized representative (POA) and could not be accessed by the facility. ACRC representative stated that they told POA personally to contact Health Net. ACRC representative stated that they were only aware of the process December 2, 2025 and only educated the POA recently. ACRC representative also stated that they were the one who provided POA with the hygienist report. ACRC representative stated that they felt the facility could have tried harder to assist R1 as it had been several months since R1 was recommended sedation dentistry, but also felt the POA was causing a delay in R1 receiving services and doesn't know what the facility could do differently considering POA's resistance.

LPA interviewed the hygienist who recommended R1 receive sedation dentistry. Hygienist stated that Health Net needs to assist with R1 obtaining sedation dentistry and can only be arranged by POA. Hygienist stated the dentist that facility is able to obtain services from would be two (2) to three (3) years out and R1's referral for sedation dentistry was an "urgent referral." Hygienist stated that POA was notified regarding arranging R1's dental with Health Net and POA could further discuss with hygienist regarding how to arrange dental for R1.

** Report continued on 9099-C **

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20251126113848

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: MEADOWOOD HOME, LLC	FACILITY NUMBER: 342700873
	VISIT DATE: 12/09/2025

NARRATIVE

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Hygienist stated that R1's treatment could not be done without sedation dentistry due to screaming and moving constantly. Hygienist stated that they can continue to maintain R1's cleaning following sedation dentistry. Hygienist stated that they don't feel the facility has done anything wrong and that facility takes very good care of the residents. Hygienist stated POA is causing a delay in R1 receiving dental treatment. LPA reviewed email correspondence dated August 26, 2025 between hygienist and ACRC dental coordinator indicating the following: "Here is what I sent to [R1's] Service Coordinators in [August 12, 2025] Below are instructions for the planning team to get this client connected to care ASAP. As of July 1st, the client's dental plan, HealthNet, has changed the way members access care. HealthNet members can now call HealthNet member services directly to request sedation dentistry and a member services rep can connect the member to care. Members can also call HealthNet dental providers directly to make appointments and no longer need an approved referral by HealthNet to go to a specialty office."

LPA reviewed Maintenance Report from hygienist dated August 9, 2025 which states "[R1] has traumatic brain injury 3/2024 and needs sedation dentistry. [R1] is complaining of pain LL and has broken tooth #18 with severe inflammation. Unable to take x rays due to conditions. [R1] also overdue for cleaning and needs root planing due to heavy calc deposits and inflammation. (...) Discussed with [POA] need for sedation dentistry to extract #18 and #29 has decay. [R1] needs full evaluation with xrays and root planing. Discussed with [POA] that after sedation dentistry, [hygienist] can help maintain with cleanings. [R1] needs urgent referral to sedation dentistry, discussed with [ACRC Representative] new Health Net options for [R1] for urgent treatment."

LPA reviewed Client Notes for R1, which included the following: on August 6, 2025, "Dental hygienist visited. Client was screaming the whole teeth cleaning procedure. Per dental hygienist, still be able to clean most stuff off [R1's] teeth." On August 20, 2025, "called [doctor's] office to schedule [R1] for sedation dentistry. Assistant said that at the time [doctor] is not accepting new clients." On August 23, 2025, "client was screaming during oral care. Staff explained importance of oral care and client understood. Client was screaming during hygiene care with DSPs. Staff asked if [R1 was] in pain. Client denied being in pain. Client stopped screaming when transferred to geri chair." On September 16, 2025, "client was screaming while staff is cleaning [R1] and during oral care. Client denies any pain when asked. Client stopped screaming when the oral care and diaper change is done. Client calmed down."

** Report continued on 9099-C **

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 59-AS-20251126113848

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: MEADOWOOD HOME, LLC	FACILITY NUMBER: 342700873
	VISIT DATE: 12/09/2025

NARRATIVE

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On September 17, 2025, "biting and hitting the staff while they cleaning [R1's] teeth" (...) "called [doctor's] office again to schedule [R1] for sedation dentistry. I was told again that [doctor] does not accept new patients at this time." On September 18, 2025, "client was screaming and hitting staff when staff helping [R1] get ready for the day and doing oral care as well." On September 24, 2025, "hitting and biting while staff and nurse cleaning [R1's] teeth." On October 6, 2025, "hit staff when they trying to clean [R1's] teeth." On October 13, 2025, "hitting the staff when cleaning [R1's] face and teeth." On October 21, 2025, "informed client that staff would begin incontinent and oral care for bedtime. Client nodded, indicating agreement. However, when care was initiated client began [continuously] screaming and hitting staff. Care was paused to assess client, client denies pain. When asked if its okay to continue, client agreed but continues to scream and hit staff. Incontinent care completed and oral care partially completed." On November 4, 2025, "client screaming, hitting and biting during oral care, educated client on importance of oral care, (...) understanding but continues to be non-compliant." On November 19, 2025, "bit and hit staff when doing oral care." On November 20, 2025, "client also screaming doing oral care and biting down on oral swab to stop oral care." On November 22, 2025, "staff notified client (...) oral hygiene would begin. The client acknowledged the information with a nod. As care was initiated, client abruptly began yelling and attempting to hit staff. Care was immediately paused for reassessment, client denies pain and agreed to allow staff to continue. Despite this, client persisted with yelling and hitting throughout the care. (...) Oral care could only be partially performed due to client hitting." On November 24, 2025, "hitting and bite when staff cleaning [R1's] teeth." On November 25, 2025, "client started to bite when staff tryed to do oral care." On November 27, 2025, "trying to bite the oral swab." On November 29, 2025, "client was screaming during personal care and oral care." On December 4, 2025, "called [doctor's] office regarding scheduling [R1] for sedation dentistry. This time they said to email the referral to their office. (...) Emailed referral today." On December 5, 2025, "received email from [doctor intake coordinator] asking for more information on [R1]." On December 8, 2025, "emailed insurance information and emergency face sheet." LPA observed multiple notes on multiple dates in which R1 was observed screaming and exhibiting aggressive behaviors.

Based on interviews conducted and records reviewed, the preponderance of evidence standards have not been met. Therefore, the above allegation is found to be UNSUBSTANTIATED. A finding that a complaint allegation 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. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025

LIC9099 (FAS) - (06/04)

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