342702896-3-17-2026-27-AS-SRIN-DU43GY-20260514181508

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342702896
Report Date: 03/17/2026
Date Signed: 03/17/2026 01:12:19 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
03/12/2026 and conducted by Evaluator Christina Valerio

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20260312113254

FACILITY NAME:	LEGACY OAKS OF SACRAMENTO		FACILITY NUMBER:	342702896
ADMINISTRATOR:	ROSALIE SULLIVAN		FACILITY TYPE:	740
ADDRESS:	1922 MORSE AVENUE		TELEPHONE:	(916) 482-7745
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	160	CENSUS: 86	DATE:	03/17/2026
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Rosalie Sullivan		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff do not prevent resident from being physically assaulted
Staff do not prevent resident from being sexually asaulted

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christina Valerio and LPA Reza Jamaly arrived unannounced to conduct a complaint investigation. LPAs met with Administrator Rosalie Sullivan, and explained the purpose of the visit.

The following has been determined as it relates to the aforementioned allegations. The complaint investigation consisted of records review of resident files (Resident 1 (R1) - Resident 2 (R2), interviews with R1 and R2, a review of staff statements, and a review of facility records.

It was alleged that R1 sexually assault R2. It was also alleged that R1 and R2 had a fight and there were no manager present.

Continues on LIC 9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 27-AS-20260312113254

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LEGACY OAKS OF SACRAMENTO	FACILITY NUMBER: 342702896
	VISIT DATE: 03/17/2026

NARRATIVE

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LPA Valerio and LPA Jamaly reviewed facility records. According to an LIC 624 dated 03/12/2026, On March 12 at approx. 2:00 PM, R1 complained to Med Tech... that roommate, R2 threw a chair at R1. Resident sustained scratches on left forearm and right elbow. First aid provided by Med Tech. No other injuries observed. Resident refused to go to ER for further evaluations. 911 called and sheriff department notified. SOC 341 submitted to ombudsman. According to the LIC 624, R1 resumed usual daily activities and R2 was relocated to another room. LPAs did not observe any notes indicating sexual abuse was observed between the residents.

According to the SOC 341, dated 03/12/2026, the SOC 341 reported "Care Staff alerted med tech that resident was bleeding. Med Tech gave the resident band-aids and asked what happened. [R1] stated that roommate [R2] threw a chair at R1 and in the process resident R2's glasses got broken. Residents were separated. 911 was called and an incident report number was given. Report # 26-77142"

LPAs reviewed statements from staff. Statement from staff indicated that R1 is the victim of physical abuse from R2. According to a review of resident records, this incident has not happened before. Notes did not indicate any suspect of sexual abuse. According to a shift note written by Staff 1 (S1) on 03/12/2026 at 5:00 AM, R1 and R2 were arguing all night and were separated with a room change.

LPAs interviewed R1. According to an interview with R1, R1 stated R2 beat R1 with a chair and sustained injuries on arm. R1 stated R1 complained to staff about R1 using most of the room and it was overbearing. R1 reported R2 was abusive by turning off the TV. R1 stated there was no sexual or physical abuse, just disturbing R1's peace.

LPAs interviewed R2. Due to communication barriers, the interview was deemed unsuccessful.

Based on all the information collected by the Department, although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the allegation(s) occurred, therefore these allegations are UNSUBSTANTIATED. California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 8, no deficiencies cited. An exit interview was held with Administrator Rosalie, and a copy of report was left at the facility.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

LIC9099 (FAS) - (06/04)

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