045002773-3-12-2026-59-AS-LCRR-DSVTVM-20260406150411

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 045002773
Report Date: 03/12/2026
Date Signed: 03/12/2026 01:14:44 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
12/18/2025 and conducted by Evaluator Rebecca Knight

COMPLAINT CONTROL NUMBER: 59-AS-20251218125151

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: 23	DATE:	03/12/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Grace Hawkns - executive director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Licensee is not adhering to facility admission agreement.- UNSUBSTANTIATED

INVESTIGATION FINDINGS:

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03/05/2026 12:00 PM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to deliver the results of a complaint investigation. LPA met with Executive Director Grace Hawkins and explained the purpose of the visit.
During the course of the investigation LPA conducted interviews, and reviewed documents.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026

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 59-AS-20251218125151

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: 03/12/2026

NARRATIVE

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Licensee is not adhering to facility admission agreement. - UNSUBSTANTIATED

It was reported that the licensee is charging an additional two weeks’ rent after a resident is no longer residing in the community, even after a resident’s belongings have been moved from the room.

During interviews there was one resident’s family that was identified as possibly not receiving the refund they were due after the resident passed away. LPA reviewed the admission agreement, monthly invoice and two credits that were issued to the resident’s family. There was no evidence that the facility has been charging residents for two additional weeks after they move out or have passed away.

This allegation is unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, and the findings are UNSUBSTANTIATED.

No deficiencies cited. Exit interview conducted and a copy of the report was provided to Executive Director Grace Hawkins.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026

LIC9099 (FAS) - (06/04)

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