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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342702896
Report Date: 06/25/2026
Date Signed: 06/25/2026 07:01:12 PM

Substantiated


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
06/22/2026 and conducted by Evaluator Kimberly Viarella
COMPLAINT CONTROL NUMBER: 27-AS-20260622091930
FACILITY NAME:LEGACY OAKS OF SACRAMENTOFACILITY NUMBER:
342702896
ADMINISTRATOR:DONNABELL GALICIAFACILITY TYPE:
740
ADDRESS:1922 MORSE AVENUETELEPHONE:
(916) 482-7745
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:160CENSUS: 78DATE:
06/25/2026
UNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Donnabell Galicia, Executive Director TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility concrete causes a hazard to residents.
Staff are not preventing diarrhea outbreak.
INVESTIGATION FINDINGS:
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On 06/25/26, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to open an investigation into the above allegations. LPA identified herself upon arrival, stated the purpose of the visit and asked to meet with the Executive Director (ED) Donnabell Galacia. The two met and a brief interviewed followed.

Regarding the allegation: "Facility concrete causes a hazard to residents"
While touring the facility, this LPA observed a section of broken concrete curb in the parking lot. It was blocking one of the parking spaces and posed a hazard to residents and visitors. LPA took a photo for documentation purposes. This allegation has been SUBSTANTIATED and this deficiency has been cited on the LIC 9099D page.

Regarding the allegation: "Staff are not preventing diarrhea outbreak"

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
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 6
Control Number 27-AS-20260622091930
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: 06/25/2026
NARRATIVE
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A resident was sent out for evaluation on 6/17/26 due to multiple episodes of vomiting and diarrhea. On 06/18/26, 12 more residents reported similar symptoms. The Executive Director, Donnabell Galicia, reported the outbreak to Public Health and to Community Care Licensing. She stated that roughly 21 residents came down with these symptoms in total. When asked what steps she took to mitigate the spread of the virus, she stated that they closed the dining room and began providing room service to all residents. She stated she made sure that staff were wearing and had extra PPE and reviewed donning and doffing procedures. Galicia also stated that she communicated with housekeeping and staff the need to sanitize surfaces. LPA asked how information was communicated to residents about the situation. Galicia stated that she explained the situation to the medication technicians and carestaff. LPA asked if there were any emails, signs, or phone calls to residents or their responsible parties about the outbreak and she stated that regular communications took place if the resident was experiencing symptoms or was sent out for evaluation.

LPA spoke to Resident Council President about the outbreak and he stated that residents did not know what was going on. He said, "Some residents thought it was a food borne illness since they closed the dining room. We weren't told anything. There was no mass communication to all residents and family members."

LPA asked what guidance Public Health provided. Galicia stated that they just sent the spreadsheet for tracking purposes. LPA contacted the nurse (N1) at the Sacramento Public Health Office that Galicia had contacted. N1 forwarded the email that was sent to Galicia. There was a spreadsheet attached for tracking purposes, but there was also a 3 page document with infection control protocols that were not followed. The guide stated that, "For ILL Residents – a. Confine symptomatic residents to their rooms until 48 hours after
symptoms cease." It also stated that the facility should "Cancel or postpone group activities until at least 48 hours after the last identified case." Family and visitors were not notified about the outbreak and some continued to visit.

The standard for the preponderance of evidence has been met and the allegation, "Staff are not preventing diarrhea outbreak" has been SUBSTANTIATED. This deficiency has been cited on the LIC 9099D page.

According to the California Code of Regulations, Title 22, no other deficiencies were cited during this visit. An exit interview was conducted and a copy of this report was provided along with APPEAL RIGHTS.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 27-AS-20260622091930
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/25/2026
Section Cited
CCR
87303(a)
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(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents...
The above
requirement was not met as evidenced by:
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The Executive Director state that the block of concrete will be trhown into the dumpster to prevent others from dislodging it from its proper place. She will send CCL a picture of it by the close of business 06/26/27.
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Based on observation, LPA observed a broken chunk of concrete blocking a parking space in the parking lot. This poses/posed a potential threat to the health safety and personal rights of residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 27-AS-20260622091930
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/26/2026
Section Cited
CCR
87470(b)(3)
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(b) In addition to subsection (a), when one or more residents... (3) There shall be separation and care of residents whose illness requires separation, including quarantine or isolation, from others.
The above requirement was not met as evidenced by:
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Executive Director stated they will review their infection control plan and the guidance from public health and will submit a summary of steps that will be taken for the remainder of this outbreak. This will be submitted by the close of business 06/27/26.
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Based on interviews with S1, S2, and R1, residents were not separated or quarantined for 48 hours after their symptoms ceased. This posed an immediate threat to the health, safety and personal rights of residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6
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
06/22/2026 and conducted by Evaluator Kimberly Viarella
COMPLAINT CONTROL NUMBER: 27-AS-20260622091930

FACILITY NAME:LEGACY OAKS OF SACRAMENTOFACILITY NUMBER:
342702896
ADMINISTRATOR:DONNABELL GALICIAFACILITY TYPE:
740
ADDRESS:1922 MORSE AVENUETELEPHONE:
(916) 482-7745
CITY:SACRAMENTOSTATE:CAZIP CODE:
95825
CAPACITY:160CENSUS: DATE:
06/25/2026
UNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Donnabell TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff do not provide adequate food service
INVESTIGATION FINDINGS:
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On 06/25/26, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to open an investigation into the above allegations. LPA identified herself upon arrival, stated the purpose of the visit and asked to meet with the Executive Director (ED) Donnabell Galacia. The two met and a brief interviewed followed.

LPA interviewed resident R1 who stated that their complaint about the food service was made because they thought that they typically received 4 pieces of bacon and on the day in question, the resident received 3 and they were "overcooked." R1 stated that they spoke to the Culinary Director about their preferences and now they always get 4 pieces and they are cooked to their liking.

This LPA also interviewed the Cuilinary Director stated that R1 was unhappy that particular day because although a serving size is 3 pieces of bacon, R1 thought it was supposed to be 4 and they are particular about how they like it prepared. It was not burnt, but it was not to their liking. The Cuilinary Director met
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 27-AS-20260622091930
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: 06/25/2026
NARRATIVE
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with R1 and learned what their specific preferences were for bacon and there have been no more issues regarding the food service at the facility.

The department found the allegation, "Staff do not provide adequate food service, " UNSUBSTANTIATED. A finding of unsubstantiated does not mean that the allegation did not happen or was untrue, it means that there was not a preponderance of evidence to show that the event was true.

According to the California Code of Regulations, Title 22, no were cited during this visit. An exit interview was conducted, and a copy of this report was provided along with APPEAL RIGHTS.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6