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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 405850480
Report Date: 07/09/2026
Date Signed: 07/09/2026 02:55:22 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
04/07/2026 and conducted by Evaluator Garrett Haner-Tomasko
COMPLAINT CONTROL NUMBER: 29-AS-20260407133349
FACILITY NAME:OAKS AT PASO ROBLES, THEFACILITY NUMBER:
405850480
ADMINISTRATOR:ROBIN MURRAYFACILITY TYPE:
740
ADDRESS:526 S RIVER ROADTELEPHONE:
(805) 239-5851
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:120CENSUS: 90DATE:
07/09/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator - Robin MurrayTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff did not follow resident's care plan.
Staff mismanaged resident's medication.
INVESTIGATION FINDINGS:
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At 10:00am, on 7/9/2026, Licensing Program Analyst (LPA) Haner-Tomasko arrived at the facility unannounced to further investigate the allegation(s) of this complaint and deliver final findings. LPA met with Administrator Robin Murray, announced who he was and the reason for the visit.

During a visit on 4/15/2026 LPA toured portions of the facility, conducted interviews, and collected relevant documentation.

On the allegation, staff did not follow resident's care plan; it was alleged that in October 2025 Resident #1’s (R1’s) level of care was changed from level 2 to level 5. Since this increase, R1’s bathing and grooming needs are not being met yet they have been paying for the level of care increase.

(Continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
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 9
Control Number 29-AS-20260407133349
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 PASO ROBLES, THE
FACILITY NUMBER: 405850480
VISIT DATE: 07/09/2026
NARRATIVE
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Interviews and record review revealed that the facility uses a point-based system to determine each resident’s level of care. There are seven levels of care, with higher levels associated with higher monthly fees.

LPA review of R1’s admission agreement indicates that upon admission in November 2024 R1 was assessed at level 2 and a service plan states this is due to requiring assistance with medication management and cognitive/orientation. The admission agreement and facility rate card indicate that a level 2 care is a $1,300 monthly fee.

A reappraisal dated 10/30/2025 documented increased care needs, including full two-person assistance for bathing, grooming reminders, and additional support with other activities of daily living (ADLs). This reappraisal placed R1 at level 5 care. The facility rate card lists level 5 care at $3,050 per month. Interviews confirmed that the primary reason for the increase was to provide full assistance with bathing.

Facility account summary statements show that R1 began being charged at the level 5 care rate on 10/29/2025 until they moved out of the facility in April 2026.

The facility uses the August Health Care Tracker system to document staff assistance with ADLs. The facility provided logs showing consistent documentation of dressing and grooming assistance for R1; however, no entries reflect staff providing bathing assistance or R1 refusal of bathing assistance. Staff interviews indicated that an audit was conducted by corporate personnel. The audit showed that when the increased bathing needs were noted on R1’s service plan in November 2025 it was not transferred over to the care tracker system to notify staff R1 required assistance with bathing. When R1’s responsible party brought this to staff attention in March 2026, staff stated more of an effort was made to provide R1 assistance. The facility has since provided a partial refund for the increase.

Based on all interviews conducted and documents obtained, R1 was charged for increased level of care including bathing which they were not receiving from November 2025 to February 2026. At this time the above allegation was found to be substantiated, there is a preponderance of the evidence to prove that the alleged violation occurred.

(Continued on LIC9099-C)

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 9
Control Number 29-AS-20260407133349
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 PASO ROBLES, THE
FACILITY NUMBER: 405850480
VISIT DATE: 07/09/2026
NARRATIVE
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Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

On the allegation, staff did not ensure resident was provided clean clothing; it was alleged that R1 has not been provided clean clothing which the level of care increase should also cover.

R1’s admission agreement lists one load of personal laundry per week at $125/month as an additional fee. Invoice statements for R1 do not list a charge for personal laundry. Interviews revealed that the base rate does include laundering of resident linens once a week, however resident personal clothing is an additional fee. Interviews also revealed there was no agreement for R1 to receive personal laundry services from facility staff and the levels of care increases do not include personal clothing laundry services. Staff stated that occasionally they would wash R1’s clothing. The facility does have personal laundry rooms that residents may use freely.

Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

On the allegation, staff did not issue resident's responsible party a refund; it was alleged that R1 has not been reimbursed for the increased level of care that they are paying for and not receiving. It was also alleged that the facility was notified that R1 would be moving out in April 2026, yet the facility had taken a full month of rent out of R1’s account for the month of April.

R1’s admission agreement states that termination by the resident is allowed with or without cause by giving the Executive Director (Administrator) thirty (30) days prior written notice and the resident is responsible for the full monthly fee until the thirty (30) day period has expired. The admission agreement also states that within thirty (30) days after the resident’s apartment has been vacated including all personal property a refund will be issued for any amount owed from the facility to the resident.

(Continued on LIC9099-C)
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC9099 (FAS) - (06/04)
Page: 8 of 9
Control Number 29-AS-20260407133349
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 PASO ROBLES, THE
FACILITY NUMBER: 405850480
VISIT DATE: 07/09/2026
NARRATIVE
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Review of R1’s admission documents revealed R1’s responsible party setup automatic payments to the facility through an automated clearing house (ACH) setup. The admission agreement states that monthly fees are due in advance by the first day of each calendar month. A review of a final invoice dated 5/1/2026 indicates the facility received the ACH payment on 4/6/2026.

Record review revealed R1’s responsible party emailed the Administrator on 3/31/2026 giving a 30-day notice that R1 will be moving out and R1’s last day at the facility was 4/6/2026. Interview and record review reveal that all of R1’s personal items were removed from the facility on 4/15/2026. A final invoice dated 5/1/2026 states the facility issued a refund for rent from 4/16/2026-4/30/2026, a pendant fee and a level 5 care increase from 4/7/2026-4/30/2026, as well as a partial refund for increased care for 11/1/2025-4/30/2026. The refund check for the amount listed on the statement was issued on 4/30/2026, postmarked 5/4/2026.

Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted, report signed, and report provided to the Licensee.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC9099 (FAS) - (06/04)
Page: 9 of 9
Control Number 29-AS-20260407133349
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 PASO ROBLES, THE
FACILITY NUMBER: 405850480
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/09/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/23/2026
Section Cited
CCR
87507(f)
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(f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments.
This requirement was not met as evidenced by:
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Administrator states they have been auditing and reviewing that all steps are conducted to communicate changes in resident services. They stated they will also conduct a formal training with the RSD and staff regarding the policy for updates on service plans and the care...
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Based on interviews and record review, the licensee did not comply with modifications made to the level of care R1 required and was billed for which poses a potential health, safety, and personal rights risk to persons in care.
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tracker system and email training and staff roster to LPA by 7/23/2026.
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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: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 9
Control Number 29-AS-20260407133349
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 PASO ROBLES, THE
FACILITY NUMBER: 405850480
VISIT DATE: 07/09/2026
NARRATIVE
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On the allegation, staff mismanaged resident's medication; it was alleged that sometime last year (2025) staff gave R1 the wrong medication. The medication was OxyContin.

This allegation was addressed during a case management – incident visit conducted on 3/26/2025 by this LPA. On 3/24/2025 the facility self-reported a medication error stating that on 3/23/2025 at approximately 10:10am staff gave R1 another resident’s medications, including a 0.5mg tablet of lorazepam and a 5mg tablet of oxycodone. The staff realized their error, reported it to the Resident Services Director who does not work at the facility anymore, and at approximately 12:15pm staff called 911. R1 was taken to the local hospital where they were observed, and R1 returned to the facility on the same day.

Based on all interviews conducted and documents obtained, at this time the above allegation was found to be substantiated, there is a preponderance of the evidence to prove that the alleged violation occurred. A citation was issued during the case management – incident visit conducted on 3/26/2025, an additional citation for this allegation will not be issued today.

Exit interview conducted, deficiency cited on LIC9099-D pages, report signed, appeal rights and report provided to the Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 9
Control Number 29-AS-20260407133349
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 PASO ROBLES, THE
FACILITY NUMBER: 405850480
VISIT DATE: 07/09/2026
NARRATIVE
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Review of R1’s medical assessment (LIC602A) dated November 2024 states R1 is able to leave facility unassisted using their electric scooter, Lyft, or Uber. R1’s service plan dated 10/31/2025 states R1 is independent with mobility and uses an electric scooter for long distances. Neither R1’s medical assessment or service plan indicate they require someone to accompany them to appointments. A facility log of transportation requests indicates R1 had an appointment on a day in August 2025. Interview’s revealed that although S1 could not take R1 to the appointment Staff #2 (S2) did take R1 to the appointment.

Title 22 regulations for residential care facilities for the elderly state that the licensee shall provide assistance in meeting necessary medical needs of residents including transportation needed which the licensee shall do so directly or make arrangements for.

Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

On the allegation, staff did not ensure facility is clean, safe, and sanitary; it was alleged that R1 moved out of this facility and moved to another facility where it was discovered that R1 had small bugs crawling all over them, out of their beard and in their mouth.

Interview and record review reveal that R1’s last day at this facility was 4/6/2026 and they moved into another facility on the same day. On 4/7/2026, staff at the other facility assisted R1 with their bathing and grooming needs and noticed small insects crawling throughout R1’s body hair. On 4/7/2026, R1 was diagnosed and treated for a form of body lice.

After R1 relocated, but prior to removing their personal items, R1’s responsible party requested the facility have the room and personal belongings inspected for the lice by pest control. On 4/15/2026 the facility had a pest control company out to inspect R1’s room. Review of the pest control invoice dated 4/15/2026 states there was no evidence of lice or related activity observed. No additional cases have been reported among staff or residents. Interviews and resident sign-in/out logs revealed that R1 spent time out of the facility on a regular basis. Based on the information available, it cannot be determined where or when R1 acquired the lice.
(Continued on LIC9099-C)
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC9099 (FAS) - (06/04)
Page: 7 of 9
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
04/07/2026 and conducted by Evaluator Garrett Haner-Tomasko
COMPLAINT CONTROL NUMBER: 29-AS-20260407133349

FACILITY NAME:OAKS AT PASO ROBLES, THEFACILITY NUMBER:
405850480
ADMINISTRATOR:ROBIN MURRAYFACILITY TYPE:
740
ADDRESS:526 S RIVER ROADTELEPHONE:
(805) 239-5851
CITY:PASO ROBLESSTATE:CAZIP CODE:
93446
CAPACITY:120CENSUS: 90DATE:
07/09/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator - Robin MurrayTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff left resident on floor for an extended period of time.
Staff did not provide transportation to resident.
Staff did not ensure facility is clean, safe, and sanitary.
Staff did not ensure resident was provided clean clothing.
Staff did not issue resident's responsible party a refund.
INVESTIGATION FINDINGS:
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At 10:00am, on 7/9/2026, Licensing Program Analyst (LPA) Haner-Tomasko arrived at the facility unannounced to further investigate the allegation(s) of this complaint and deliver final findings. LPA met with Administrator Robin Murray, announced who he was and the reason for the visit.

During a visit on 4/15/2026 LPA toured portions of the facility, conducted interviews, and collected relevant documentation.

On the allegation, staff left resident on floor for an extended period of time; it was alleged that R1 fell on a day in March of this year and it is believed that R1 was on the floor for an extended period of time before staff found them because R1 had soiled their brief. Staff stated that R1 fell due to passing out.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 9
Control Number 29-AS-20260407133349
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 PASO ROBLES, THE
FACILITY NUMBER: 405850480
VISIT DATE: 07/09/2026
NARRATIVE
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Review of notes documented by staff in R1’s electronic records reveal that on 3/25/2026 at approximately 4:00pm care staff checked on R1 and found them sitting on their couch with soiled clothing, care staff notified a med-tech and when they asked R1 what had happened, R1 stated they had fallen and passed out in the bathroom. Staff called 911, emergency responders arrived and consulted with R1’s responsible party, and R1 was transported to the local hospital for further evaluation. R1 returned to the facility on the same day at approximately 9:45pm.

Review of the Device Activity Report that tracks resident pendant and bathroom pull station use throughout the facility has no logged events for devices R1 could have used to alert staff of their fall. Interviews revealed R1 did have a pendant, and LPA observed a pull station in R1’s bathroom.

Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

On the allegation, staff did not provide transportation to resident; it was alleged that R1 had an appointment last year that Staff #1 (S1) was supposed to take R1 to. S1 was not able to take R1 to their appointment and instead got R1 an Uber to transport R1 to the appointment. It was alleged that someone from the facility should have been there accompanying R1.

R1’s admission agreement states that the facility will make available scheduled transportation to medical and dental appointments. Scheduled transportation within a twelve-mile radius of the facility is provided and there may be an extra charge for services outside the service area and for escort services for those who need assistance.



(Continued on LIC9099-C)
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 9