392701177-9-16-2025-27-AS-LKIG-DMHV3W-20251016160525

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701177
Report Date: 09/16/2025
Date Signed: 09/16/2025 03:34:57 PM

Substantiated

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
08/25/2025 and conducted by Evaluator Michael Bilger

COMPLAINT CONTROL NUMBER: 27-AS-20250825065134

FACILITY NAME:	TELECARE WHITE LANE		FACILITY NUMBER:	392701177
ADMINISTRATOR:	DANICA MORRISON		FACILITY TYPE:	737
ADDRESS:	1775 WHITE LANE		TELEPHONE:	(510) 621-9064
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95215
CAPACITY:	4	CENSUS: 3	DATE:	09/16/2025
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Danica Morrison		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff did not prevent residents from eloping from the facility
Staff did not ensure that facility fences were repaired.

INVESTIGATION FINDINGS:

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On 9-16-25 at 2:00pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver finding for the allegations noted above. LPA met with Administrator Danica Morrison and explained the purpose of the visit. During this investigation LPA conducted interview with interim Administrator and reviewed incident report dated 9-2-25. The above allegations were included in another complaint previously of similar nature and investigated (Complaint 27-AS-20250819124925) which resulted in the following:

Allegation: Staff did not prevent residents from eloping from the facility. Based on interviews and record reviews, on 8-2-2025 at approximately 8:30pm, resident1 (R1) went to bed. Staff4 (S4) was in line of sight of R1's door. At approximately 8:45pm, S4 went on break with permission from lead staff (S3). A second staff member (S2) was completing chores elsewhere in the facility. At approximately 8:50pm, staff member walked past R1's room and observed door open with R1 not inside. S3 was alerted as well as all other staff on duty. Staff began to search for R1 who was located at a neighbor's yard fully disrobed at approximately 9:00pm {Cont. on 9099}

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

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-20250825065134

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: TELECARE WHITE LANE	FACILITY NUMBER: 392701177
	VISIT DATE: 09/16/2025

NARRATIVE

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Staff reported R1 was back inside facility by 9:10pm. Based on interview and record review, it was revealed that R1 was absent without supervision for approximately 15 minutes. It was further revealed through interview that R1 eloped due to inadequate supervision in that staff was given a break without adequate coverage to ensure R1's safety and whereabouts. No injuries resulted from this elopement event. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.

Allegation: Staff did not ensure that facility fences were repaired. LPA conducted interviews, record reviews, and facility observation as noted above. Based on interviews and record reviews, it was revealed that on 8-2-2025, R1 eloped from facility and found in a neighbor's yard fully disrobed. It was further revealed that R1 was without supervision for approximately 15 minutes. On 8-27-2025, LPA observed multiple fenced boards down with neighbor's yard exposed and accessible on left side of facility's property. LPA observed unfilled pool located on neighbor's property. It was further observed that this area of the facility is accessible to residents in care. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.

The above substantiated allegations of similar nature were already investigated and cited in complaint #27-AS-20250819124925, as a result no citations issued today. An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights provided.

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025

LIC9099 (FAS) - (06/04)

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