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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342702896
Report Date: 04/13/2026
Date Signed: 04/13/2026 04:01:20 PM

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
04/07/2026 and conducted by Evaluator Christina Valerio
COMPLAINT CONTROL NUMBER: 27-AS-20260407151307
FACILITY NAME:LEGACY OAKS OF SACRAMENTOFACILITY NUMBER:
342702896
ADMINISTRATOR:ROSALIE SULLIVANFACILITY TYPE:
740
ADDRESS:1922 MORSE AVENUETELEPHONE:
(916) 482-7745
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:160CENSUS: 83DATE:
04/13/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Mery Lyn OteroTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Facility staff are not providing activities for the residents in care.
Facility staff are not providing transportation for residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christina Valerio and LPA Reza Jamaly arrived unannounced to conduct a complaint investigation. LPAs were met by Interim Executive Director Marilyn , and explained the purpose of the visit.

LPA Valerio and LPA Jamaly were provided a Termination of Employment for Staff 1 (S1), which held the position for Life Enrichment Coordinator. This position's sole responsibility was to carry out the activities planned for the community. S1 was terminated on February 13, 2026. Based on resident council meeting minutes and an interview conducted with Interim Administrator Mery Lyn Otero, they are still in process of hiring a Life Enrichment Coordinator.

Continues on LIC 9099-C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026
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-20260407151307
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: LEGACY OAKS OF SACRAMENTO
FACILITY NUMBER: 342702896
VISIT DATE: 04/13/2026
NARRATIVE
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According to the Reporting Party (RP), the facility fired the staff conducting activities. During LPAs visit on April 13, 2026, LPAs observed the activities room doors to be closed with a sign stating a meeting was in progress. According to the activity schedule, Blackjack was the scheduled activity for 2:00 PM. The calendar indicated that there was nothing planned for 3:00 PM and had a letter "S" inputted on the time slot. LPAs observed residents watching television and writing for their leisure. There was not a staff led activity being held during this time.

LPA Valerio and LPA Jamaly reviewed a Termination of Employment letter for Staff 2 (S2), which was the Transportation Driver. According to Interim Administrator Mery Lyn, they decided to terminate S2 because it was learned that S2 would cancel resident appointments and would not communicate with management regarding the missed appointments.

LPA Valerio and LPA Jamaly reviewed resident council meeting notes dated April 2, 2026. Notes stated, "residents are not happy with transportation. There is a lack of communication and too many cancellations."

According to an interview with Interim Administrator Mery Lyn, LPAs learned that S2 would show up to work late or leave work early, which caused residents to miss their appointments or scheduled outings. LPAs learned that the duties of a transportation driver include accommodating all resident appointments or outings. S2 would turn residents away if they wanted to go somewhere, such as Safeway, and did not have an appointment.

LPAs learned that a new transportation driver was hired on April 13, 2026. Before this date, the facility utilized Lyft or Uber to transport residents to their appointment from April 7 - April 13, 2026. If there was an emergency, Alpha One was contacted.

Per California Code of Regulations (CCR) - Title 22, deficiencies are being cited on the attached LIC 9099 - D page. Appeal rights were provided. An exit interview was held, and a copy of this report was provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 27-AS-20260407151307
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: LEGACY OAKS OF SACRAMENTO
FACILITY NUMBER: 342702896
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/13/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/04/2026
Section Cited
CCR
87219(f)
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87219 Planned Activities(f)In facilities licensed for fifty (50) persons or more, one staff member shall have full-time responsibility to organize, conduct and evaluate planned activities, ... This requirement was not met as evidenced by:
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The licensee stated they have hired a new Life Enrichment Coordinator and are waiting on the person to accept the position. Licensee to send copy of employment packet and proof of hire by POC due date.
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Based on records reviews and interviews, the licensee did not ensure the facility had a ful time person to carry out activities since Feburary 13, 2026, which poses a potential health, safety, and personal rights risk to residents in care.
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Type B
05/04/2026
Section Cited
CCR
87464(f)((6)
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87464 Basic Services (f) Basic services shall at a minimum include: (6) Arrangements to meet health needs, including arranging transportation, as specified in Section 87465, Incidental Medical and Dental Care Services. This requirement was not met as evidenced by:
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The Licensee stated that they have terminated S2 on April 7, 2026 and have hired a new transportation driver on April 13, 2026. Licensee to send a copy of new employee file and copy of schedule by POC due date.
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Based on records review and interviews, the licensee did not ensure S2 provided transportation to all resident appointments, which poses a potential health, safety, and personal rights risk to residents in care.
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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: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026
LIC9099 (FAS) - (06/04)
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