342702896-6-26-2026-27-AS-LRIS-DVYS5E-20260714133413

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342702896
Report Date: 06/26/2026
Date Signed: 06/26/2026 01:43:33 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
01/15/2026 and conducted by Evaluator Albert Johnson

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20260115114001

FACILITY NAME:	LEGACY OAKS OF SACRAMENTO		FACILITY NUMBER:	342702896
ADMINISTRATOR:	JONATHAN AGUILAR		FACILITY TYPE:	740
ADDRESS:	1922 MORSE AVENUE		TELEPHONE:	(916) 482-7745
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	160	CENSUS: 82	DATE:	06/26/2026
		UNANNOUNCED	TIME BEGAN:	12:36 PM
MET WITH:	D. Galicia		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Resident sustained injuries due to staff neglect or physical abuse

INVESTIGATION FINDINGS:

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On 6/26/2026, Licensing Program Analyst (LPA) Albert Johnson arrived unannounced to deliver findings for this complaint investigation. LPA met with Administrator and explained the purpose of the visit.

Allegation: Resident sustained injuries due to staff neglect or physical abuse
On 1/22/26 LPA interviewed the ED. It was stated that R1 was sent out to Kaiser for a swollen hand. R2 stated this had happened before to R1 and they had to cut her ring off. According to S2, NOC shift never noticed swollen hand. R1 has history of falls but due to cognitive impairment they are unable to state whether the swollen hand was due to a fall or not.
Based on Interviews and record review, the above allegation is unsubstantiated.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.
Exit interview was conducted with the licensee. Appeal Rights were issued, and a copy of this report was left at the facility.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2026

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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