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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701177
Report Date: 12/05/2025
Date Signed: 12/05/2025 01:33:55 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
10/23/2025 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20251023104311
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:
12/05/2025
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Danica MorrisonTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff inappropriately transported a client
INVESTIGATION FINDINGS:
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On 12-5-2025 at 10:35am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver and discuss findings for the allegation noted above. LPA met with program administrator Danica Morrison and explained the purpose of the visit. During this investigation, LPA conducted interviews with two staff members and reviewed additional documentation pertaining to information regarding this allegation. LPA also reviewed facility staffing schedule from July-September 2025.

Allegation: Staff inappropriately transported a client. Based on interviews conducted it was revealed that two different staff members were witnessed to have been driving facility van carrying at least one resident in a “reckless-like” manner which included excessive hard braking and hard turning. Interviews conducted further revealed the consistency of the allegation which was described as hard braking and hard turning in a reckless manner.
{Cont. on 9099C}
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
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 5
Control Number 27-AS-20251023104311
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: 12/05/2025
NARRATIVE
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Additionally, interviews conducted revealed the driver’s name (staff member) as consistent with the name mentioned in the allegation received.

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 program administrator, and a copy of this report was provided. LIC 811 and appeal rights provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 27-AS-20251023104311
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: 12/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/15/2025
Section Cited
CCR
80072(a)(2)
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80072 Personal Rights. (a) …each client shall have personal rights which include, but are not limited to, the following: (2) To be accorded safe, healthful and comfortable accommodations...to meet his/her needs. This requirement was not met as evidenced by:
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Licensee will ensure staff training on safe driving skills. Proof of completed training to be submitted to LPA by POC due date.
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 Based on interview and record review Licensee did not ensure safe and comfortable accommodations for a resident in that staff members transported a client in a manner described as reckless-like. This posed a potential health and safety risk for a resident 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: 12/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
10/23/2025 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20251023104311

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:
12/05/2025
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Danica MorrisonTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff does not keep the facility free from mold
Staff has inadequate record keeping
Staff mishandled a client's personal belongings
Staff hit a client
INVESTIGATION FINDINGS:
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On 12-5-2025 at 10:35am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver findings for the allegations noted above. LPA met with program administrator Danica Morrison and explained the purpose of the visit. During this investigation, LPA conducted interviews with eight staff members and reviewed facility file documentation including copies of various incident reports and staffing schedules for July – September 2025. LPA also reviewed text messages and other written statements received and pertaining to above allegations. Additionally, LPA conducted facility observations on 10-28-2025 and 11-19-2025.
Allegation: Staff does not keep the facility free from mold. LPA conducted interviews, record reviews, and observations as noted above. Based on observations conducted, which included but not limited to: Viewing behind facility refrigerators, windowsills throughout facility, and outside areas of the facility. LPA did not observe any appearance of mold-like substances within facility property.

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

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20251023104311
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: 12/05/2025
NARRATIVE
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Interviews conducted did not reveal any corroborated statements of mold presence within facility property. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff has inadequate record keeping. This allegation states that on at least one occasion, staff falsified information on an incident report. Based on record reviews as noted above, it was revealed that although multiple incidents were reported by facility in the form of a special incident report (SIR), additional documentation existed to support the purpose and information within the reports. A review of incident reports from August 2025 to September 2025 could not confirm if staff falsified information or if information was otherwise incorrect. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff mishandled a client’s personal belongings. Based on interviews conducted, it was revealed that items consisting of bean bags were removed from an unoccupied room in which they were stored and taken from facility. Interviews further revealed that these items were delivered by the facility’s corporation and did not become the property of residents as they were never used by the residents. Furthermore, it was revealed that these items were removed due to potential safety and sanitary concerns. Interviews conducted did not reveal any corroborated statements of residents’ items being mishandled. As a result, the preponderance of evidence standard is not met, and this allegation is UNSUBSTANTIATED.

Allegation: Staff hit a client. Allegation stated that on or about September 18, 2025, a staff member slapped a resident. The allegation further stated that a slapping sound was heard but not witnessed. LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, no corroborated statement or evidence existed to suggest a resident was hit by a staff member. Additional documentation reviewed revealed that the information noted above was also reported to facility management. As a result, there is not a preponderance of evidence to conclude a resident was hit by a staff member. Therefore, 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 program 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: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5