392700993-6-20-2022-27-AS-KHOS-CFTMYA-20220628100113

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700993
Report Date: 06/20/2022
Date Signed: 06/20/2022 03:29:52 PM

Unsubstantiated

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
06/08/2022 and conducted by Evaluator Michael Bilger

COMPLAINT CONTROL NUMBER: 27-AS-20220608144500

FACILITY NAME:	A1 DEL MONTE STOCKTON		FACILITY NUMBER:	392700993
ADMINISTRATOR:	SAINI, ANURADHA		FACILITY TYPE:	740
ADDRESS:	517 E. FULTON STREET		TELEPHONE:	(209) 910-5910
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95204
CAPACITY:	158	CENSUS: 85	DATE:	06/20/2022
		UNANNOUNCED	TIME BEGAN:	12:41 PM
MET WITH:	Anuradha Saini		TIME COMPLETED:	03:24 PM

ALLEGATION(S):

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9

Staff do not ensure that residents are adequately fed

INVESTIGATION FINDINGS:

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On 6-20-22 at 12:41pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to continue an complaint investigation for the allegation listed above. LPA met with Administrator Anuradha Saini and explained the purpose of the visit. LPA conducted interviews and reviewed diet orders for Resident1 (R1), R2, R3, R4, R5, an R6. LPA also reviewed blood sugar reading for R1-R6. Based on interviews and record reviews, it was determined that adequate food items and amounts were provided to residents. It was further determined that blood sugars for R1-R6 were stable during the period of 5/30/22 to 6/3/22. LPA also reviewed food receipts submitted by Administrator on 6-16-22 which revealed adequate food supply available for residents in care.

Based on interviews and record reviews, there is not a preponderance of evidence to conclude that residents in care were not fed adequately. Therefore, this allegation is UNSUBSTANTIATED. An exit interview was conducted with Anuradha Saini and a copy of this report was left with Anuradha.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Michael Bilger	TELEPHONE: 916-862-4722
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022

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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