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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700527
Report Date: 02/29/2024
Date Signed: 03/04/2024 01:47:36 PM

Substantiated


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
12/20/2023 and conducted by Evaluator Liza King
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20231220082024
FACILITY NAME:A1 DEL MONTE ASSISTED LIVING LODIFACILITY NUMBER:
392700527
ADMINISTRATOR:SAINI, ANURADHAFACILITY TYPE:
740
ADDRESS:1321 S FAIRMONT AVENUETELEPHONE:
(209) 334-3436
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:145CENSUS: DATE:
02/29/2024
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Judy RordiguesTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
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9
Staff does not ensure adequate quality and quantity of food is provided to residents in care
INVESTIGATION FINDINGS:
1
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5
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9
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12
13
Licensing Program Analyst (LPA) Avelina Martinez and Licensing Program Manager (LPM) Liza King arrived at the facility unannounced on 02/29/2024 at 8:00 AM to deliver complaint findings, LPA Martinez met with Judy Rodriguez and Daisy Aguilar and Stephen Ratlift and explained the purpose of the visit.
Throughout the course of the investigation, LPM King and LPA Martinez conducted interviews, toured the facility, and reviewed facility records. LPM King observed breakfast service today. Residents were served eggs, toast, and oatmeal. No fruit was provided during today's breakfast meal. Additionally, meals were severed in Styrofoam containers, which did not keep the food warm, and did not the protect safety, acceptability and nutritive values of food being served. Moreover, the facility began implementing a meal menu in February 2024. The first meal menu provided to residents in care was in February 2024 for March 2024.
As a result of this investigation, the Department finds these allegations to be Substantiated. A finding that the complaint is substantiated means that the allegations are valid because the preponderance of the evidence standard has been met. Deficiencies cited on todays date on Complaint 27-AS-20240222155121.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Krystall MooreTELEPHONE: (916) 263-4707
LICENSING EVALUATOR NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024
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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