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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700993
Report Date: 07/28/2022
Date Signed: 07/28/2022 01:26:51 PM

Unfounded


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
07/25/2022 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20220725143916
FACILITY NAME:A1 DEL MONTE STOCKTONFACILITY NUMBER:
392700993
ADMINISTRATOR:SAINI, ANURADHAFACILITY TYPE:
740
ADDRESS:517 E. FULTON STREETTELEPHONE:
(209) 910-5910
CITY:STOCKTONSTATE: CAZIP CODE:
95204
CAPACITY:158CENSUS: 88DATE:
07/28/2022
UNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Anuradha SainiTIME COMPLETED:
01:23 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident did not receive a copy of the admission agreement
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 7-28-22 at 11:55am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegation noted above. LPA met with Anuradha Saini and explained the purpose of the visit. During this investigation, LPA interviewed Administrator and Resident1. LPA also reviewed facility file documentation including admission agreement for R1. Based on interviews and record reviews, it was determined that R1 received a copy of her signed admission agreement on 6-20-22. During interview with R1 on 7-28-22, LPA observed admission agreement on R1's nightstand. Additionally, it is indicated in the admission agreement that R1 acknowledged receipt of admission agreement on 10-29-2021 which contains a fee schedule and acknowledgment of handbook received. Based on interview and record review, the preponderance of evidence standard is not met, and this allegation is UNFOUNDED.

An exit interview was conducted with Anuradha Saini and a copy of this report was left with Anuradha.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Michael BilgerTELEPHONE: 916-862-4722
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2022
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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