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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700368
Report Date: 05/19/2021
Date Signed: 05/19/2021 03:34:30 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/14/2021 and conducted by Evaluator Treana White
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20210514102152
FACILITY NAME:COMMONS ON THORNTON, THEFACILITY NUMBER:
392700368
ADMINISTRATOR:MILLER, CAROLFACILITY TYPE:
740
ADDRESS:10711 THORNTON RDTELEPHONE:
(209) 476-1500
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:110CENSUS: 94DATE:
05/19/2021
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Carol Miller, Executive DirectorTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Facility is not kept clean
Facility is malodorous
INVESTIGATION FINDINGS:
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On 05/19/2021, Licensing Program Analyst (LPA) T. White conducted an unannounced complaint investigation regarding the above allegations. LPA White discussed the purpose of the visit and the elements of the allegations with Executive Director, Carol Miller.

On 05/19/2021, LPA toured the facility including but not limited to 10 apartments, bathrooms, kitchen, dining room area, common area and courtyard. Based on observation, LPA observed facility is kept clean. LPA observed staff cleaning apartment rooms and dining room. ED stated the facility apartments have scheduled cleaning once a week and facility sanitation is completed multiple times a day. However, LPA is not able to prove or disprove facility was not kept clean.

Report continues on 9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Treana WhiteTELEPHONE: (510) 566-9342
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2021
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 27-AS-20210514102152
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: COMMONS ON THORNTON, THE
FACILITY NUMBER: 392700368
VISIT DATE: 05/19/2021
NARRATIVE
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On 05/19/2021, LPA toured the facility and observed the facility to be odor free. LPA inspected 10 apartments and observed 9 of 10 apartments were odor free. However, LPA did observe R1/R2 apartment to have an odor of what appeared to be animal urine and feces odor. LPA observed dog pads throughout the residents apartment kitchen, living room, and bedroom. Although R1/R2 apartment had an odor, there is insufficient information to say the facility is "malodorous".

Based on information obtained, LPA determined these allegations to be UNSUBSTANTIATED- means that although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. There are no citations being issued today.

Exit interview conducted with Executive Director and copy of report emailed.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Treana WhiteTELEPHONE: (510) 566-9342
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2