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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700368
Report Date: 10/18/2024
Date Signed: 10/18/2024 12:30:33 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
07/30/2024 and conducted by Evaluator Kesha Lewis
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20240730141410
FACILITY NAME:COMMONS ON THORNTON, THEFACILITY NUMBER:
392700368
ADMINISTRATOR:ARBIOS, MARIEFACILITY TYPE:
740
ADDRESS:10711 THORNTON RDTELEPHONE:
(209) 476-1500
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:110CENSUS: 98DATE:
10/18/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Marie ArbiosTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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9
Licensee did not provide resident with a general description of additional costs of the general increase for residents per the admission agreement

Licensee did not provide residents with changes in level of care that would result in an increase in monthly fees
INVESTIGATION FINDINGS:
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On 10-18-24, Licensing Program Analyst (LPA) Kesha Lewis arrived unannounced to continue a complaint investigation for the allegations noted above. LPA met with Administrator Marie Arbios and explained the purpose of the visit. LPA requested a copy of facility's admission agreement and other pricing structure documentation.

The facility was able to provide detailed information and show written policy about what is to be done when there is a price increase for the facility. LPA finds the facility followed the policy in the incidentsnotifiing resident on the price increase. Therefore, this complaint is UNSUBSTANTIATED. A finding that a complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted. copy of report given.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Liza KingTELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Kesha LewisTELEPHONE: (916) 764-1024
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
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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