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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701177
Report Date: 10/07/2025
Date Signed: 10/07/2025 12:23:36 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-20250825125702
FACILITY NAME:TELECARE WHITE LANEFACILITY NUMBER:
392701177
ADMINISTRATOR:DANICA MORRISONFACILITY TYPE:
737
ADDRESS:1775 WHITE LANETELEPHONE:
(510) 621-9064
CITY:STOCKTONSTATE: CAZIP CODE:
95215
CAPACITY:4CENSUS: 2DATE:
10/07/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Danica MorrisonTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Staff did not safeguard client's confidential information
INVESTIGATION FINDINGS:
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On 10-7-2025 at 10:15am, Licensing Program Analysts (LPAs) Michael Bilger and Sommer Hayes arrived unannounced to deliver findings for the allegation noted above. LPA met with Administrator Danica Morrison and explained the purpose of the visit. During this investigation, LPA conducted an interview with one staff member and reviewed the facility’s internal investigation regarding the allegation noted above.
Allegation: Staff did not safeguard client’s confidential information. Based on interview and record review it was determined that on or about 7-14-2025 a resident’s daily summary was sent to the family of a different resident. The internal investigation identified staff member who sent this information in error which allowed unauthorized access. Additionally, it was revealed that on or about 10-1-2025 medical information regarding a resident was erroneously sent to a family member of another resident. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED. Citation is issued under Title 22, Division 6 and noted on LIC 9099D. An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights and LIC 811 provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 27-AS-20250825125702
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/17/2025
Section Cited
CCR
80070(c)(1)
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Client Records. (c) All information and records obtained from or regarding clients shall be confidential. (1) The licensee shall be responsible for safeguarding the confidentiality of record contents. This requirement was not met as evidenced by:
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Licensee will develop and submit a plan outlining procedures on safeguarding resident file documentation. Plan to be submitted to LPA by POC due date.
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Based on interview and record reviews, facility staff sent a resident’s file contents to a family member of another resident’s family resulting in unauthorized access. This posed a potential health, safety, and resident rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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-20250825125702

FACILITY NAME:TELECARE WHITE LANEFACILITY NUMBER:
392701177
ADMINISTRATOR:DANICA MORRISONFACILITY TYPE:
737
ADDRESS:1775 WHITE LANETELEPHONE:
(510) 621-9064
CITY:STOCKTONSTATE: CAZIP CODE:
95215
CAPACITY:4CENSUS: 2DATE:
10/07/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Danica MorrisonTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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2
3
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9
Staff did not follow doctor's orders for client in care
INVESTIGATION FINDINGS:
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On 10-7-2025 at 10:15am, Licensing Program Analysts (LPAs) Michael Bilger and Sommer Hayes arrived unannounced to deliver findings for the allegation noted above. LPA met with Administrator Danica Morrison and explained the purpose of the visit. During this investigation, LPA conducted an interview with one staff member and reviewed medication log sheets and physician orders for resident1 (R1).
Allegation: Staff did not follow doctor’s orders for client in care. Based on interview and record reviews noted above it was revealed that physician orders for R1 in place from July to September 2025 were consistent with medication log sheets. A review of physician orders further revealed various medication changes which were noted on the log sheets. Log sheets also indicated R1 received medication consistent with the physician orders. No additional evidence corroborated the above allegation. As a result, there is not a preponderance of evidence to prove staff did not follow physician orders, therefore, this allegation is UNSUBSTANTIATED. An allegation of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Administrator and a copy of this report was provided. Appeal rights provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3