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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700993
Report Date: 08/15/2023
Date Signed: 08/15/2023 02:59:51 PM


Document Has Been Signed on 08/15/2023 02:59 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



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: 147DATE:
08/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Lucky KaurTIME COMPLETED:
03:15 PM
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On 8-15-23 at 2:00pm, Licensing Program Analysts (LPAs) Michael Bilger and Arvin Villanueva arrived unannounced to conduct a case management visit regarding facility's current volume of 9-1-1 calls. LPAs met with Assistant Executive Director (AED) Lucky Kaur and explained the purpose of the visit. During today's case management, LPAs discussed the volume of 9-1-1 calls which revealed a consistent increase from June to August of 2023. LPAs offered resources for alternative methods of meeting resident emergency needs as warranted. AED stated some emergency calls are initiated by residents in care for various purposes. Additional technical advise was offered to AED to involved facility's nurse practitioner and Physician to evaluate reasons for 9-1-1 calls in attempts to determine if non-emergency methods may be used to meet resident needs.

At this time AED has agreed to the following: (1) Accepting of resources for non-emergency needs, (2) Communicate with nurse practitioner and physician for evaluating resident emergency needs, (3) Continue to call 9-1-1 for emergencies warranting such intervention and per regulatory requirements.

No citations issued today as a result of this case management. An exit interview was conducted with Lucky Kaur and a copy of this report was provided to Lucky.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Michael BilgerTELEPHONE: 916-862-4722
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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