502701482-1-20-2026-27-AS-LKIG-DQPVWC-20260126154743

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 502701482
Report Date: 01/16/2026
Date Signed: 01/20/2026 09:20:30 AM

Unsubstantiated

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
11/10/2025 and conducted by Evaluator Charlie Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20251110080912

FACILITY NAME:	ADENA CARE HOME		FACILITY NUMBER:	502701482
ADMINISTRATOR:	OCHOA, ROBERTO		FACILITY TYPE:	735
ADDRESS:	2673 PATTERSON RD		TELEPHONE:	(209) 869-2803
CITY:	RIVERBANK	STATE: CA	ZIP CODE:	95367
CAPACITY:	15	CENSUS: 15	DATE:	01/16/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Michael Talbot		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff do not treat resident with respect

INVESTIGATION FINDINGS:

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Unannounced complaint visit made out to this facility on 01/16/2026 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility representative, Michael Talbot, who was briefly interviewed at this time. This LPA requested that the facility representative go ahead and contact the facility designated Administrator, Roberto Ochoa, to inform him that CCL was present at this time.
It was learned that the facility designated Administrator would not be able to be present at this time for this complaint visit.
Current census was 15 residents.
The purpose of this visit was given to the facility representative at this time. This LPA was here today to present the findings of this investigation to this facility, and it's representative, at this time.
Based on a review of the forms and documents gathered during this investigation, it was learned that R1 had a history of AWOLs and not complying with house rules as outlined in the original admission agreement. It was learned that several attempts were made to assist with this elopement behavior but R1 did not comply with the policies set forth and continued to engage in leaving this facility without proper notification to the

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026

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 27-AS-20251110080912

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: ADENA CARE HOME	FACILITY NUMBER: 502701482
	VISIT DATE: 01/16/2026

NARRATIVE

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facility staff nor sign in/out as required for all facility residents.
As a result, this facility issued R1 an eviction notice on 11/07/2025 in order to inform R1 that if R1 continued to engage in this behavior then this facility would have no choice but to no longer allow R1 to remain as a resident.
It was learned that the eviction process was finalized and R1 was moved out of this facility on 12/02/2025 to another licensed care facility.
Based on interviews conducted, it was learned that there were no reported incidents where facility staff disrespected R1 while R1 was a resident at this facility. It was learned that facility staff attempted to redirect and assist R1 with complying with house rules since all facility residents were mandated to follow them in order to be in compliance with their individualized care plans.
It was learned that after several AWOLs and the issuance of the 30-day eviction notice, R1 knew that R1's time here as a resident was coming to a close and no longer adhered to the facility rules.
Multiple phone calls were attempted out to R1 without any success.
Multiple phone calls were attempted out to the case worker for R1 without any return calls as well.

As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegation may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred.

There were no deficiencies observed or cited at this time.

Exit Interview

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2026

LIC9099 (FAS) - (06/04)

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