<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701388
Report Date: 08/24/2026
Date Signed: 08/24/2026 12:50:55 PM

Unfounded


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
08/24/2026 and conducted by Evaluator Kesha Lewis
COMPLAINT CONTROL NUMBER: 27-AS-20260824111324
FACILITY NAME:BALANCE ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
392701388
ADMINISTRATOR:MONIQUE CHIBFACILITY TYPE:
740
ADDRESS:1321 S. FAIRMONT AVENUETELEPHONE:
(209) 334-3436
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:136CENSUS: 71DATE:
08/24/2026
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Monique Chib TIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Refund not provided
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 08/24/26. Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to open a complaint investigation into the above allegation. LPA identified themselves upon arrival, stated the purpose of their visit, and asked to meet with the Designated Facility Administrator. LPA met with Executive Director (ED) MONIQUE CHIB.

LPA requested the following documentation accounts receivable for resident 1 (R1) Any proof of a refund issued to R1 or their responsible party. The facility provided a statement showing that the pro-rated payment that was attempted to be collected had been declined, also the reporting party could only provide proof that a stop payment charge was taken from her account. The reporting party verified with their bank that there were no funds withdrawn. Therefore, the above allegation is UNFOUNDED. As a result of this investigation, the preponderance of evidence standard is not met, therefore, this allegation is UNFOUNDED. The allegation is false, could not have happened, and/or is without a reasonable basis. Exit interview and copy of the report given.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Kesha Lewis
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2026
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 1