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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 576804194
Report Date: 03/17/2026
Date Signed: 03/17/2026 03:06:41 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/24/2025 and conducted by Evaluator Jill Nakagawa
COMPLAINT CONTROL NUMBER: 21-AS-20251124093021
FACILITY NAME:WOODLAND GARDENS SENIOR LIVINGFACILITY NUMBER:
576804194
ADMINISTRATOR:PAZ, DIANAFACILITY TYPE:
740
ADDRESS:240 PALM AVETELEPHONE:
(530) 661-0574
CITY:WOODLANDSTATE: ZIP CODE:
95695
CAPACITY:100CENSUS: 69DATE:
03/17/2026
UNANNOUNCEDTIME BEGAN:
02:08 PM
MET WITH:Alka Ralh, Administrator-in-TrainingTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Facility mismanaged resident’s medications.
INVESTIGATION FINDINGS:
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On March 17, 2026, Licensing Program Analyst (LPA) Nakagawa arrived at Woodland Gardens Senior Living to complete a complaint investigation regarding the allegation listed above and deliver findings. LPA met with the administrator-in-training, Alka Ralh.

The complaint alleges that Facility mismanaged resident’s medications. The complainant stated that there were 3 boxes of medications, including medications which the facility had failed to refrigerate. The complainant provided photos of boxes of medications. The label states that medications may be refrigerated but not required.

Continued on 9099-C....

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
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 2
Control Number 21-AS-20251124093021
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: WOODLAND GARDENS SENIOR LIVING
FACILITY NUMBER: 576804194
VISIT DATE: 03/17/2026
NARRATIVE
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Continued from 9099.....

LPA reviewed medication compliance which showed that one of the medications should be refrigerated once the pouch is opened and then used within two weeks. In addition, outside parties stated that none of the medications which the resident (R1) was receiving required constant refrigeration storage. Based on the information provided by outside sources the medication was not improperly stored. The reporting party also alleges that the facility ordered medications unnecessarily when there were ample supplies. The reporting party alleges that the facility mis-managed R1’s medications by storing them improperly, dispensing them incorrectly, and continuing to order medications unnecessarily when there were already ample supplies. Interviews with outside parties stated that the prescriptions were refilled per physicians orders. Title 22 Regulations do not allow for a facility to determine that a prescription should or should not be refilled. It is the responsibility of the prescribing physician.

LPA Nakagawa received a medication release form that was signed by the facility representative and the responsible party. There were no discrepancies noted by either party at that time. LPA Nakagawa received pictures from the responsible party showing that they received three file boxes of medications from the facility. The facility also had pictures of medications released to the responsible party, but there was only one file box. In review of records from outside parties, there were many prescriptions ordered on auto-refill set up by the responsible party. Records reviewed by LPA also indicate there were multiple doctors prescribing medications. The facility is required to follow the orders of physicians and receives authorization through the pharmacy. LPA found that although there were many prescriptions ordered they were all under the order and authorization of the doctors and the pharmacy so there is no fault of the facility. The allegation that Staff mismanaged resident's medications is unsubstantiated. Although the allegation may have occurred there is not a preponderance of evidence therefore the allegation is unsubstantiated.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2