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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700993
Report Date: 07/30/2021
Date Signed: 07/30/2021 03:26:46 PM

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:
(925) 222-0430
CITY:STOCKTONSTATE: CAZIP CODE:
95204
CAPACITY:158CENSUS: 52DATE:
07/30/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Anuradha SainiTIME COMPLETED:
02:32 PM
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On 7/30/21 at 10:50am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a case management visit to address concerns previously expressed by a resident. Concerns expressed were lack of food quality and quantity and insufficient staffing. LPA met with Administrator Anuradha Saini and explained the purpose of the visit. At 11:25am LPA interviewed Resident1 (R1), R2 at 11:45am, R3 at 11:55am, and R4 at 12:10pm. LPA also interviewed Administrator and Administrator designee. LPA also reviewed facility records including current menu and actual hours worked for the period of 7-15-21 to 7-30-21.

Based on interviews and record reviews, it was determined that caregivers were on duty as assigned and able to meet the needs of residents in care across morning, evening, and night shifts. LPA reviewed current menu and observed lunch meal at 12:25pm which consisted of sufficient amounts of food to meet regulatory guidelines. Additionally, based on resident interviews, it was determined that quality and quantity amounts of food were suitable, but a variety in menu choices is requested.

LPA toured facility inside and out with Administrator designee. LPA observed facility to be clean and sanitary and in good repair. Temperature inside facility was 76*F throughout. LPA toured kitchen area which was clean and sanitary. Food supply was sufficient upon observation.

Per California Code of Regulations, Title 22 there were no deficiencies observed or cited during today's case management visit.

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

DATE: 07/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021
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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