392700993-3-25-2024-27-AS-KHOS-D4DP3X-20240416105816

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392700993
Report Date: 03/25/2024
Date Signed: 03/25/2024 03:15:15 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
01/23/2024 and conducted by Evaluator Albert Johnson

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20240123152134

FACILITY NAME:	A1 DEL MONTE STOCKTON		FACILITY NUMBER:	392700993
ADMINISTRATOR:	SANDEEP SAINI		FACILITY TYPE:	740
ADDRESS:	517 E. FULTON STREET		TELEPHONE:	(209) 910-5910
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95204
CAPACITY:	158	CENSUS: 156	DATE:	03/25/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Sunny Saini and Lakhbir Kaur		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Facility staff is not responding to residents' request in a timely manner
Facility staff is serving residents' meals too cold

INVESTIGATION FINDINGS:

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On 3/25/24, LPA Johnson arrived unannounced to deliver findings. LPA met with Sunny and Lucky.

Allegation: Facility staff is not responding to residents' request in a timely manner. Review of records and interviews with residents the facility is answering calls, the times vary in each situations and on the average the calls are being answered within 5 to 15 minutes after the call buttons are pushed. Residents interviewed confirmed that the staff make good efforts at trying to answer all calls timely. The facility has installed an updated call system in each residents room. The system notifies the front desk and alerts staff on their communication devices when the call buttons are pushed. by residents.

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Albert Johnson	TELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024

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-20240123152134

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: 03/25/2024

NARRATIVE

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Allegation: Facility staff is serving residents' meals too cold. The department reviewed the food temperature record with the desired temperatures and actual food temperatures for three meals daily. The records reviewed indicated that the facility's kitchen is maintaining the desired temperatures according to regulatory requirements. Some residents interviewed confirmed that the facility is serve hot food to their expectation and other say the food is "warm; not cold and not hot."

The department has investigated the allegations and determined them to be unsubstantiated. There is not a preponderance of evidence to conclude the allegations are factual, therefore, these allegations are UNSUBSTANTIATED.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Albert Johnson	TELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024

LIC9099 (FAS) - (06/04)

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