045002773-8-14-2025-59-AS-LCRR-DKZUJT-20250829153804

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045002773
Report Date: 08/14/2025
Date Signed: 08/14/2025 01:29:36 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH 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
07/02/2025 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 59-AS-20250702090756

FACILITY NAME:	ROSELEAF OROVILLE		FACILITY NUMBER:	045002773
ADMINISTRATOR:	BAXTER, STACEY		FACILITY TYPE:	740
ADDRESS:	1900 20TH ST		TELEPHONE:	(530) 538-8200
CITY:	OROVILLE	STATE: CA	ZIP CODE:	95965
CAPACITY:	60	CENSUS: 28	DATE:	08/14/2025
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Stacey Baxter - administrator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff do not follow reporting requirements. - UNSUBSTANTIATED
Staff did not obtain medical care for resident in a timely manner. - UNSUBSTANTIATED
Staff do not follow infection control guidelines. - UNSUBSTANTIATED

INVESTIGATION FINDINGS:

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08/14/2025 12:30 PM Licensing Program Analyst (LPA) Rebecca Knight, made an unannounced visit to the facility and met with Executive Director Stacey Baxter. The purpose of this visit was to deliver the results of a complaint investigation.

During the course of the investigation LPA interviewed the administrator, and 6 staff. The following documents were reviewed: related incident reports.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025

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 59-AS-20250702090756

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ROSELEAF OROVILLE	FACILITY NUMBER: 045002773
	VISIT DATE: 08/14/2025

NARRATIVE

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Staff do not follow reporting requirements. - UNSUBSTANTIATED

It was reported that the administrator did not report an outbreak of Covid 19 to licensing or public health.

On 07/07/2025 LPA received a report from Executive Director reporting 3 residents and 2 staff had tested positive for Covid 19. ED confirmed outbreak had been reported to Butte County Public Health.

ED stated that first staff tested positive on 06/23/2025, the first resident tested positive on 07/01/2025, the second staff tested positive on 07/05/2025.

According to Butte County Public Health it is not considered an outbreak until three or more people test positive for Covid 19. This threshold was reached on 07/05/2025 and the facility reported to CCLD on 07/07/2025. This allegation is unsubstantiated.

Staff did not obtain medical care for resident in a timely manner. - UNSUBSTANTIATED

It was reported that a resident had fever, diarrhea, nausea, vomiting, and lethargy symptoms for 3 days before being sent to hospital where they tested positive for Covid 19.

LPA reviewed the following incident reports: 06/30/2025 A resident was sent to hospital for diarrhea and vomiting. 07/04/2025 A resident was having a hard time walking, complained of hip pain and was sent to hospital for observation. Both of these residents were diagnosed with Covid 19.

During staff interviews it was learned that the first positive resident was sent to the hospital on 06/30/2025 due to diarrhea, vomiting and fatigue. Stated this resident had not been feeling well but initially refused to be sent out. The second positive resident was sent out to hospital because they were not at baseline. This resident was diagnosed and treated for UTI.

This allegation is unsubstantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 59-AS-20250702090756

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ROSELEAF OROVILLE	FACILITY NUMBER: 045002773
	VISIT DATE: 08/14/2025

NARRATIVE

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Staff do not follow infection control guidelines.- UNSUBSTANTIATED

It was reported that the facility is not following infection control guidelines and residents are not being isolated during a Covid 19 outbreak.

LPA reviewed incident report dated 07/07/2025 that states the facility implemented their infection control plan on 07/01/2025 when the first resident tested positive. Report states facility implemented masks in the building, PPE stations, isolation of any resident or employee who has tested positive for 5 days or until symptoms pass, increased sanitization.

Staff stated when they found out there was Covid in the building they started to clean more starting the first week of July, but no staff or residents were tested.

This allegation is unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are UNSUBSTANTIATED. No deficiencies cited. Exit interview conducted and a copy of the report was provided to Executive Director Stacey Baxter.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025

LIC9099 (FAS) - (06/04)

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