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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701177
Report Date: 10/28/2025
Date Signed: 10/28/2025 02:01:07 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
08/27/2025 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20250827115412
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:
10/28/2025
UNANNOUNCEDTIME BEGAN:
10:28 AM
MET WITH:Danica MorrisonTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Client sustained an unexplained injury while in care
INVESTIGATION FINDINGS:
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On 10-28-2025 at 10:28am, Licensing Program Analyst (LPA) Michael Bilger 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 interviews with six staff members and reviewed facility documentation including individual program plan (IPP) for resident1 (R1), individual behavior support plan (IBSP) for R1, incident reports, various photographs, hospital paperwork, and various body/skin check and other observation forms pertaining to R1.
Allegation: Client sustained an unexplained injury while in care. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews it was determined that R1 was observed to have a red colored mark under his chin area on or about 8-27-25 as well as a red colored mark on his right arm on or about 9-6-2025. Interviews conducted revealed that body checks are expected to be performed for R1 on a routine basis.

{Cont. on 9099C}
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
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-20250827115412
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: 10/28/2025
NARRATIVE
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Records reviewed revealed that body checks for R1 have been conducted regularly. Additionally, it was revealed through investigation that R1 experienced a behavior episode on 9-5-2025 resulting in R1’s lip bleeding. Staff noted this injury and facilitated medical attention as documented in a previous incident report addressing this event. A facility internal investigation did not reveal a concise reason for the bruising noted above. Interviews conducted did not reveal any corroborated evidence to conclude a clear reason for how bruising was obtained. Given this information as well as the incident noted above, it is determined that although R1 did sustain a red mark under his chin and on his right arm, it is undermined how the bruising occurred, or if bruising occurred while in care as a result of a regulatory violation.. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED. A finding 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.


SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3