392700644-8-20-2020-27-AS-LKIG-BSNPP8-20200820112903

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700644
Report Date: 08/05/2020
Date Signed: 08/20/2020 08:35:31 AM

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
04/13/2020 and conducted by Evaluator Ruth Wallace

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20200413145504

FACILITY NAME:	SOMERFORD PLACE - STOCKTON		FACILITY NUMBER:	392700644
ADMINISTRATOR:	ANDERSON, LESLIE		FACILITY TYPE:	740
ADDRESS:	3530 DEER PARK DRIVE		TELEPHONE:	(209) 951-6500
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95219
CAPACITY:	60	CENSUS: 49	DATE:	08/05/2020
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Telephone Call - Administrator Leslie Anderson		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff are sleeping during working hours.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Wallace contacted the facility via telephone to deliver amended finding on a complaint investigation on 08/20/2020 due to COVID-19 and pre-cautionary measures. LPA identified herself and discussed the purpose of the call and the elements of the allegation with Administrator Leslie Anderson.

LPA reviewed all submitted documents, interviewed Staff, Hospice Nurses, and Administrator from different shifts at the facility. The information provided in the complaint alleged that staff have been sleeping during working hours. LPA conducted interviews and observations; LPA could not confirm or deny the allegation occurred.

There was not a preponderance to prove or disprove that the allegation occurred as reported therefore it was Unsubstantiated. Copy of 9099 with finding was sent via email with "read receipt". Administrator will return with her signature on copy via email to LPA Ruth Wallace.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Ruth Wallace	TELEPHONE: (619) 323-4509
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2020

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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