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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700489
Report Date: 12/16/2025
Date Signed: 12/16/2025 01:03:00 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
09/29/2025 and conducted by Evaluator Melissa Parks
PUBLIC
COMPLAINT CONTROL NUMBER: 59-AS-20250929124120
FACILITY NAME:PALMS COURT IFACILITY NUMBER:
342700489
ADMINISTRATOR:OGUNDWIN, ADEOLAFACILITY TYPE:
740
ADDRESS:6821 LINCOLN AVETELEPHONE:
(916) 993-8166
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 0DATE:
12/16/2025
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Adeola OgundwinTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Insufficient staffing
Records not kept on property
staff unable to communicate with residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Melissa Parks arrived on Tuesday December 16, 2025, to conclude a complaint investigation regarding the above allegations. LPA met with Administrator Adeola and explained the purpose of the visit.

LPA learned that R1 had lived at the facility since September 2024. At the time the complaint was filed with the Department, R1 was the only resident at the facility. R1’s room was in the back of the facility. There is a fire door which is kept closed which separates the resident living rooms from the common area and the main entry to the facility. LPA learned that if someone was knocking or ringing the doorbell, and staff were assisting R1 in their bedroom, they would not be able to hear it. LPA reviewed R1’s facility file while at the facility on 9/29/2025. LPA verified that R1’s file contained all the required paperwork. LPA attempted to contact R1’s POA on three separate occasions and was unsuccessful. LPA did not have any difficulty understanding and communicating with staff at the facility.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Melissa Parks
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
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 59-AS-20250929124120
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: PALMS COURT I
FACILITY NUMBER: 342700489
VISIT DATE: 12/16/2025
NARRATIVE
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Based on information obtained during the investigation, LPA finds the allegations to be UNSUBSTANTIATED- a finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

Exit interview. A copy of this report was provided to the Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Melissa Parks
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2