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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701388
Report Date: 08/28/2025
Date Signed: 08/28/2025 04:40:44 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
06/04/2025 and conducted by Evaluator Liza King
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250604161942
FACILITY NAME:BALANCE ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
392701388
ADMINISTRATOR:RACHELLE REYESFACILITY TYPE:
740
ADDRESS:1321 S. FAIRMONT AVENUETELEPHONE:
(559) 313-8062
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: 67DATE:
08/28/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Merilyn OteroTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Facility failed to provide comfortable temperature
Facility failed to provide Windows and sliders that are operable
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Bilger and Licensing Program Manager (LPM) Liza King arrived unannounced to conduct facility observations and interviews regarding the above allegations. We were met by licensee designee Merilyn Otero and explained the purpose of our visit.
During a facility visit conducted by LPA Renee Campbell on 06/05/25 and todays subsequent visit, it has beeeen confirmed by interview withh the Administrator and documentation receieved includeing repair invoices that the AC stopped working for room #’s, 1, 3, 4, 5 and 7. No IR was submitted at the time. (Administrator wrote an IR upon LPA Campbell's request during this visit.) Residents went without AC between May 21, 2025 and June 03, 2025 when portable AC’s arrived. During the period they didn’t have AC, staff checked on residents every two hours and inquired if they felt comfortable. It residents expressed feeling hot, fans were provided.

Cont.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Krystall Moore
LICENSING EVALUATOR NAME: Liza King
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
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 5
Control Number 27-AS-20250604161942
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: BALANCE ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 392701388
VISIT DATE: 08/28/2025
NARRATIVE
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 During todays visit 0n 8/28/25 a window in the Memory Care was observed to be broken and a resdients slider was inoperable.
Based on observation and interviews it was determined the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations is being cited on the attached LIC 9099D. Appeal Rights have been provided and an exit interview with designee Otero was conducted to discuss these finding.
SUPERVISORS NAME: Krystall Moore
LICENSING EVALUATOR NAME: Liza King
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 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
06/04/2025 and conducted by Evaluator Liza King
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250604161942

FACILITY NAME:BALANCE ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
392701388
ADMINISTRATOR:RACHELLE REYESFACILITY TYPE:
740
ADDRESS:1321 S. FAIRMONT AVENUETELEPHONE:
(559) 313-8062
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: DATE:
08/28/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Merilyn OteroTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Facility failed to provide nutritious meals
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Bilger and Licensing Program Manager (LPM) Liza King arrived unannounced to conduct facility observations and interviews regarding the above allegations. We were met by designee Merilyn Otero and explained the purpose of our visit.
During a facility visit conducted today LPM interviewed the chef whom provided meal substitutions provided by the registered dietician. During interview it was confirmed that noodles, vegatables, grilled cheese sandwich, quesidilla, peanut butter and jelly and cottage cheese are stable substitutions. Interview also revealed that interviews with resdidents to determine preferences had not occured. At this time there is not evidence that supports that residents were not provided alternatives to meat therefore this allegation has been found to be UNSUBSTANTIATED . A finding of unsubstantiated means the allegation may have happened or is valid andt there is not a preponderance of evidence to prove that the alleged violation occurred.
No citations were issued. An exit interview with Merilyn Otero was conducted to discuss these finding.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Krystall Moore
LICENSING EVALUATOR NAME: Liza King
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 27-AS-20250604161942
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: BALANCE ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 392701388
VISIT DATE: 08/28/2025
NARRATIVE
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No citations were issued. An exit interview with XXXXX was conducted to discuss these finding.
SUPERVISORS NAME: Krystall Moore
LICENSING EVALUATOR NAME: Liza King
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 27-AS-20250604161942
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: BALANCE ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 392701388
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/29/2025
Section Cited
CCR
87303(a)
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(a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.This was not met as evidenced by:
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Poratble AC have been prurchased and are currently being used. Additionally poratble ACs are being used in resident rooms. Sliders and windows will be checked by maintenance and repaired by eod 8/29/25.
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 Residents went without AC between May 21, 2025 and June 03, 2025 when portable AC’s arrived. During the period they didn’t have AC, staff checked on residents every two hours and inquired if they felt comfortable. It residents expressed feeling hot, fans were provided. Additionally sliders and windows were pobserved to be inoperable. This poses a potential health and safety risk since the weather was not excessively hot during these days.
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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: Krystall Moore
LICENSING EVALUATOR NAME: Liza King
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5