342702896-9-23-2025-27-AS-LKIG-DMERTJ-20251013131826

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342702896
Report Date: 09/23/2025
Date Signed: 09/23/2025 01:20:07 PM

Unfounded

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
09/18/2025 and conducted by Evaluator Noel Wolf Petersen

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20250918122016

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:	DATE:	09/23/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Ashley Sylv		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Facility does not ensure that water is clean and drinkable.

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Noel Wolf Petersen, arrived unannounced on 9/23/25 at 9:00 to conduct a complaint investigation, LPA met with the administrator Ashley Sylv and explained the purpose of the visit and the above allegation.

LPA asked the facility to check in with thier local water board that services the facility about getting thier water tested for metal/inorganic compound/bactereological elements. A copy of Local water board test results should be sent to the department if they get them. As the water quality falls outside the scope of title 22 this agency has investigated the complaint. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/ or is without a reasonable basis. The LPA will cross report to sacremento water board.

Appeal rights provided. Exit interview conducted, a copy of the report was read and left with the administrator.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025

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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