345920108-3-26-2025-59-AS-SCAA-DF62AM-20250326171346

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 345920108
Report Date: 03/25/2025
Date Signed: 03/26/2025 05:15:46 PM

Document Has Been Signed on 03/26/2025 05:15 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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

FACILITY NAME:	OAKWOOD MEADOWS ASSISTED LIVING		FACILITY NUMBER:	345920108
ADMINISTRATOR/ DIRECTOR:	TORGERSEN, DANIEL		FACILITY TYPE:	740
ADDRESS:	7241 CANELO HILLS DR		TELEPHONE:	(916) 722-2800
CITY:	CITUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY: 78		CENSUS: 73	DATE:	03/25/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:30 PM
MET WITH:	Danny Torgersen, Administrator and Karen Padilla, Director of Nursing		TIME VISIT/ INSPECTION COMPLETED:	04:50 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Sabrina Calzada and Ombudsman arrived unannounced to conduct a case management inspection. LPA met with Director of Nursing, Karen Padilla and Administrator, Danny Torgersen, and stated the reason for the inspection.LPA, Ombudsman and both facility managers discussed the following incidents recently reported to the Department, as follows: Resident (R1) had an altercation with resident (R2) who entered their room on March 23, 2025 (7:00 pm). Staff stated (R2) may have wandered in (R1's) room, mistakenly, and (R1) may have tried to be aggressive with (R2) and then (R2) may have hit (R1) on the lip. Both residents were sent to the ER. (R1) returned with sutures to their upper left lip and (R2) remains in the hospital as they have shown behaviors there. Resident (R3) was observed to be on the floor with their left eye cheek swollen on March 22, 2025. Staff stated resident fell going to the bathroom. Resident was sent out for emergency treatment and returned the same day. Resident (R4) was found on the floor in the bathroom on March 22, 2025. Resident was observed with a skin tear on their left forearm and a fracture of their right hip. DON stated the hospital will keep resident for 3-4 additional days before sending them to a skilled nursing. Resident was receiving physical/occupational therapy before the fall and moved in from a skilled nursing facility. Resident (R5) was observed to be in (R1's) room on March 18, 2025, (6:00 pm) by staff after hearing (R1) screaming. Staff was able to redirect (R5) from (R1's) room and there were no injuries observed. Both residents are being monitored for behaviors. (R1) didn't remember the incident and (R5) is currently non-verbal and taking antibiotics for a Urinary Tract Infection, which could have caused the confusion.

NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2025

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

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: OAKWOOD MEADOWS ASSISTED LIVING	FACILITY NUMBER: 345920108
	VISIT DATE: 03/25/2025

NARRATIVE

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809C-1.. Resident (R6) was interviewed by LPA and the Ombudsman. Resident was observed to be resting in their room at the time of the discussion. Resident expressed concern about their medical group not addressing the reason for the recent trip to the emergency room on March 24, 2025. Resident confirmed she is receiving showers at least twice weekly, and staff is assisting with applying lotion for their skin condition. The DON confirmed that (R6) was prescribed a 10-day oral antibiotic and a topical creme following yesterday's visit to the emergency room.

It appears the facility followed its protocols in sending all residents out for further medical evaluations.

LPA requested updated care plans for residents (R2) and (R5) and hospital discharge paperwork for the last several hospital visits for (R6).

There are no citations issued in this report.

Exit interview. Copy of report to be emailed following today's inspection.

NAME OF LICENSING PROGRAM MANAGER: Maribeth Senty
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2025

LIC809 (FAS) - (06/04)

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