405809547-1-27-2026-29-AS-KBUY-DRP5KR-20260226190159

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405809547
Report Date: 01/27/2026
Date Signed: 01/27/2026 05:41:15 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/08/2025 and conducted by Evaluator Melisa Rankin

COMPLAINT CONTROL NUMBER: 29-AS-20251208105330

FACILITY NAME:	OAKS AT NIPOMO, THE		FACILITY NUMBER:	405809547
ADMINISTRATOR:	RONALD C. FREEMAN		FACILITY TYPE:	740
ADDRESS:	177 MARY AVENUE		TELEPHONE:	(805) 723-5206
CITY:	NIPOMO	STATE: CA	ZIP CODE:	93444
CAPACITY:	122	CENSUS: 89	DATE:	01/27/2026
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Ronald Freeman		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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Staff did not follow infection control requirements

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rankin conducted a subsequent complaint visit to the facility above to issue final findings. LPA met with Administrator Ron Freeman and explained the purpose of the visit. During the initial visit on 12/11/25 LPA Rankin toured the facility, took images of relevant areas and interviewed staff. This report is being given at the conclusion of an annual.

Allegation: Staff did not follow infection control requirements

It was alleged that the facility was not adhering to infection control protocols. Allegation state, on 11/29/25 Resident 1’s (R1) room had bodily fluid “all over” following an emergency and the reporting party stated the room was never cleaned. On 12/7/25 R1 moved from this room, on 12/11/25 LPA toured R1’s room where the emergency occurred, the window was open and it appeared that the carpet had recently been cleaned, there was spots of blood observed on the light switch above the kitchen counter that leads into the sleeping area, on the lower right corner of the refrigerator, a finger sized spot on the wall of restroom about 2 feet off the ground between the toilet and the shower. During the time of LPA’s visit the resident has been out of the room for three days. Continue on 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026

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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Control Number 29-AS-20251208105330

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: OAKS AT NIPOMO, THE	FACILITY NUMBER: 405809547
	VISIT DATE: 01/27/2026

NARRATIVE

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R1 is a resident of the assisted living side of the facility and has more independence. Staff that had seen the room stated that it was not a normal clean up, multiple care staff interviewed stated that resident had a bloody nose with excessive bleeding, incident report states fall and facial trauma. Staff interviewed stated resident was found in their restroom but had started to bleed in their bedroom area and had walked to their restroom.

Administrator confirmed regular housekeeping occurred on 12/4/25. Nine staff were interviewed regarding infection control and cleanup procedures. All stated that bodily fluids are cleaned immediately by care staff, followed by housekeeping disinfection. Four staff confirmed they were present during the emergency and began cleaning immediately after R1 was transported to the hospital. Infection control training was conducted on 9/17/25. All staff interviewed demonstrated knowledge of the procedures and the importance of cleaning up as quickly as possible.

LPA observed evidence of bodily fluids in R1’s room; however, it could not be confirmed whether these spots resulted from the original emergency incident or occurred while R1 occupied the room after returning. At the time of the visit the room was locked and unoccupied and is expected to be cleaned before reuse. The situation did not pose an immediate health and safety risk to residents in care, this is considered a technical violation and no citations are being issued at this time.

A Technical Violation is issued related to this allegation, for section 87470 (a)(2)(C) Spills of blood and other potentially infectious materials and surfaces shall be promptly cleaned and disinfected.

Exit interview conducted, and a copy of this report was issued.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Melisa Rankin
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2026

LIC9099 (FAS) - (06/04)

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