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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 576804194
Report Date: 04/17/2025
Date Signed: 04/17/2025 11:20:29 AM

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
04/16/2025 and conducted by Evaluator Jill Nakagawa
COMPLAINT CONTROL NUMBER: 21-AS-20250416150428
FACILITY NAME:WOODLAND GARDENS SENIOR LIVINGFACILITY NUMBER:
576804194
ADMINISTRATOR:PAZ, DIANAFACILITY TYPE:
740
ADDRESS:240 PALM AVETELEPHONE:
(530) 661-0574
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY:100CENSUS: 67DATE:
04/17/2025
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Alka Ralh, Director of Resident CareTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Facility is in disrepair.
Facility staff did not adhere to handwashing protocols.
Facility has mold.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jill Nakagawa arrived at Woodland Gardens on April 17, 2025 for the purpose of initiating a complaint investigation regarding the above allegations and met with the corporation’s maintenance director Dale Garrett and Director of Resident Care, Alka Ralh. FAcility administrator was off site at the time of visit.

The complaint alleges that Facility is in disrepair. LPA Nakagawa inspected the facility and found renovations were being made in the Memory Care unit. The cabinetry and sink in the large common room have been removed and replacement is being overseen by Staff (S1) and appears to be conducted in a timely manner with consideration to the health and safety of the residents. The entire area has been sealed off from floor to ceiling to keep residents safe and the area free of dust. Therefore, the allegation that the Facility is in disrepair is unsubstantiated.
(Continued on 9099-C)




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

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
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 21-AS-20250416150428
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: 04/17/2025
NARRATIVE
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(Continued from 9099)

The complaint alleges that Facility staff did not adhere to handwashing protocols. The complainant states that staff are using residents’ sinks for required hand hygiene. LPA interviewed Staff (S2,S3, S4) who stated that the staff were provided with two restrooms directly outside the memory care unit for hand washing; as well as being provided with gloves and hand sanitizer. If necessary, there is one vacant room (#57), which is locked, but may be accessed by staff. Therefore, the allegation that Facility staff did not adhere to handwashing protocols is unsubstantiated.

Complaint alleges that the Facility has mold. The complainant states that they were told by staff that there was mold. LPA Nakagawa spoke with S1 regarding the possibility of mold. S1 stated that the area had been thoroughly cleaned but there was testing for mold being done, however results of the testing has not been received yet. Therefore, the claim that the Facility has mold is unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated.

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

DATE: 04/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2