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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701380
Report Date: 03/18/2026
Date Signed: 03/20/2026 11:59:30 AM

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
01/26/2026 and conducted by Evaluator Charlie Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260126122156
FACILITY NAME:OMO'S HOMEFACILITY NUMBER:
392701380
ADMINISTRATOR:OIFOH, PATIENCE OMOZUWAFACILITY TYPE:
735
ADDRESS:14536 SILVER CREEK DRTELEPHONE:
(909) 254-3793
CITY:LATHROPSTATE: CAZIP CODE:
95330
CAPACITY:4CENSUS: 2DATE:
03/18/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Nehis Oviawe and Patience OifohTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Resident eloped from the facility without staff knowledge
INVESTIGATION FINDINGS:
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Unannounced complaint visit made out to this facility on 03/18/2026 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Patience Oifoh, who was briefly interviewed at this time.
Current census was 2 residents.
The purpose of this complaint visit was to present to this facility, and it's representative, the results from the investigation to the above allegations at this time.
Based on a review of the forms and documents obtained during this investigation, it was learned that R1 was placed at this facility on a respite basis for only 4 days. The resident, R1, came to this facility on 01/04/2026 in the morning hours and had lunch and dinner while present at this facility.
It was learned that there were forms and documents to support that R1 had elopement tendencies which were made known to the facility Administrator prior to admission.
It was learned that R1did elope that same evening on 01/04/2026 through their bedroom window and left the premises on foot.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
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 3
Control Number 27-AS-20260126122156
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: OMO'S HOME
FACILITY NUMBER: 392701380
VISIT DATE: 03/18/2026
NARRATIVE
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It was learned that facility staff were present to make sure that R1 did not elope from R1's bedroom and supervised R1 on a one-on-one basis.
It was learned that this facility was not updated, in physical plant measures, to be able to accept a resident who was an elopement risk since there weren't any physical plant measures put into place at this time. It was learned that there weren't door alarms, exit alarms, or any alert system put into place to address elopement behaviors at this time.
It was learned that the resident eloped from this facility and was observed by their family member, who had electronic tracking on R1, when they checked on R1's status to make sure that R1 was still present at this facility. The family member observed that R1 was no longer present at this facility address and contacted the facility, and its staff, to inform them that R1 had eloped. It was learned that the facility staff were unaware that R1 had left this facility through the bedroom window if not by the family member notifying them of the elopement. It was learned that the local law enforcement agency was then notified and staff, along with R1's family members, conducted a search of the surrounding community in an attempt to locate R1. It was learned that they were successful in locating R1 who was then released to the care and supervision of R1's family members and did not return to this facility.

As a result of this investigation, this LPA found the allegation to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegation was valid because the preponderance of the evidence standard had been met.

The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes.

Appeal rights were printed and a copy was left with the facility designated Administrator at this time.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20260126122156
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: OMO'S HOME
FACILITY NUMBER: 392701380
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/19/2026
Section Cited
CCR
85068.4(a)(4)
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Acceptance and Retention Limitations
The licensee shall not accept or retain the following:
Persons who require more care and supervision than is provided by the facility.
This facility was found to be deficient as evidenced by the acceptance of a resident
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The facility designated Administrator stated that prior to the acceptance of any resident with elopement or exit seeking behaviors, a thorough review, will be completed in regards to the needs of the residents versus the capabilities of the facility in meeting those needs. A statement of correction, along with
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with known history of elopement and exit seeking tendencies. It was observed that this facility did not have any physical plant updates to address exit seeking behavior and elopement risks which posed an immediate threat to the Health, Safety, and Personal Rights of all residents in care.
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a review of this section, 85068.4, will be completed and submitted into CCL for review by this LPA by the due date.
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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.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
LIC9099 (FAS) - (06/04)
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