<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700527
Report Date: 02/29/2024
Date Signed: 02/29/2024 02:45:17 PM

Unfounded


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
02/05/2024 and conducted by Evaluator Avelina Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20240205113239
FACILITY NAME:BALANCE ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
392700527
ADMINISTRATOR:RODRIGUEZ, JUDYFACILITY TYPE:
740
ADDRESS:1321 S FAIRMONT AVENUETELEPHONE:
(209) 334-3436
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:145CENSUS: 63DATE:
02/29/2024
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Daisy Aguilar and Judy RodriguezTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Unlawful eviction
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 02-29-2024 at 8:00 AM, Licensing Program Analyst (LPA) Avelina Martinez and Licensing Program Manager (LPM) Liza King conducted an unannounced facility visit to deliver compliant findings, LPA Martinez and LPM King met with Daisy Aguilar and Judy Rodriguez and explained the purpose of today's visit.

Throughout the investigation, LPA Martinez reviewed facility files and conducted interviews. The facility reported to LPA Martinez on January of 2024 that resident 1 was having aggressive behaviors towards themself, staff, and residents. Facility staff called law enforcement, and resident 1 was taken to the hospital. It was also learned resident 1 picked up their belongings and signed themselves out of the facility on February 09, 2024. Therefore, this allegation is unfounded.

This agency has investigated the complaint alleging (Unlawful eviction). We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report was provided to the facility.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Liza KingTELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Avelina MartinezTELEPHONE: (916) 431-8935
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
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