392700993-12-5-2023-27-AS-LKIG-CYNUZM-20231219150146

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700993
Report Date: 12/05/2023
Date Signed: 12/05/2023 03:40:30 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/25/2023 and conducted by Evaluator Michael Bilger

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20230825145223

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: 143	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	10:28 AM
MET WITH:	Lucky Kaur		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff are violating resident's personal rights
Staff made inappropriate comments toward resident
Staff interfers in resident's financial affairs
Staff threatened residents with eviction

INVESTIGATION FINDINGS:

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On 12-5-23 at 10:28am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the complaint allegations noted above. LPA met with assistant executive director Lucky Kaur and explained the purpose of the visit. During this investigation LPA conducted interviews with 6 staff members and 6 residents and additional witnesses. Additionally, LPA reviewed facility file documentation including admission agreements, safeguard agreements, inventory sheets, surety bond, various eviction notices previously issued, and facility’s plan of operation. LPA also conducted facility observation on 10-17-23.

Allegation: Staff are violating resident’s personal rights. LPA conducted interviews as stated above. This allegation included the facility allegedly calling social security offices on behalf of residents without permission. Based on interviews conducted, it was revealed that no corroborated statements exist which determine a violation of personal rights. It was further determined through interviews that social security offices do not reveal information without the resident, or resident’s responsible party present.

{Cont. on 9099C}

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Michael Bilger	TELEPHONE: (916) 862-4722
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

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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Control Number 27-AS-20230825145223

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: A1 DEL MONTE STOCKTON	FACILITY NUMBER: 392700993
	VISIT DATE: 12/05/2023

NARRATIVE

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Additionally, interviews conducted revealed no further violation of other personal rights. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff made inappropriate comments towards resident. LPA conducted interviews as stated above. The investigation revealed staff addressed residents appropriately. LPA did not observe staff making inappropriate comments towards a resident or in reference to a resident. Based on interviews conducted, it was revealed that no corroborated statements exist which determine staff making inappropriate comments towards residents. As a result, the preponderance of evidence standard is not met, and this allegation UNSUBSTANTIATED.

Allegation: Staff interferes in resident’s financial affairs. LPA conducted interviews and record reviews including admission agreements, plan of operation, surety bond, inventory sheets, and safeguard agreements stating facility may hold debit cards for specific residents who have agreed to this practice. Based on interviews and record reviews, it was revealed that licensee currently holds debit cards for eight (8) residents in care. It was further revealed through record reviews and interviews that all residents and applicable responsible parties have signed and agreed to safeguard agreements allowing licensee to manage debit cards and withdraw funds on behalf of residents for purposes of paying monthly rents. As a result, there is not a preponderance of evidence to conclude that facility staff have engaged in a practice of interfering in residents’ financial affairs, therefore, this allegation is UNSUBSTANTIATED.

Allegation: Staff threatened residents with eviction. LPA conducted interviews as stated above. Based on interviews conducted, there were no corroborated statements which reveal threats of eviction given by staff towards residents. Furthermore, the investigation revealed that although facility has previously issued eviction notices, such notices contained required regulatory language and components to determine a legitimate reason for evictions, or have been revised accordingly to meet regulation requirements. As a result, there is not a preponderance of evidence to conclude staff have threatened residents with eviction, therefore, this allegation is UNSUBSTANTIATED.

An exit interview was conducted with Lucky Kaur and a copy of this report was provided to Lucky. Appeal rights provided.

SUPERVISOR'S NAME: Liza King	TELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Michael Bilger	TELEPHONE: (916) 862-4722
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

LIC9099 (FAS) - (06/04)

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