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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701388
Report Date: 08/28/2025
Date Signed: 08/28/2025 02:34:34 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
07/29/2025 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20250729152109
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: 76DATE:
08/28/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Merylyn OteroTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff do not ensure resident room is clean
Facility staff do not ensure resident hygiene needs are met
Facility staff do not ensure that the resident bed is working
Facility staff denied residents going on outings
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8-28-25 at 10:00am, Licensing Program Analyst (LPA) Michael Bilger and Licensing Program Manager (LPM) Liza King arrived unannounced to deliver findings for the allegations noted above. LPA met with licensee designee Merylyn Oltero and explained the purpose of the visit. During this investigation, LPA conducted interview with five staff members. Additionally, LPA conducted facility observations on 8-6-25 and 8-28-25. LPA also reviewed additional written evidence as part of this investigation.

Allegation: Facility staff does not ensure resident room is clean. LPA conducted interviews and observations as noted above. Based on observation on 8-28-25, it was revealed that room #14 contained feces on bed and floor. Additionally, based on interviews conducted, it was revealed that staff required to maintain cleanliness of rooms were not performing adequate diligence in regards to maintaining clean room within facility. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
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 6
Control Number 27-AS-20250729152109
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
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Facility staff do not ensure resident hygiene needs are met. LPA and LPM conducted interviews and observations as noted above. Based on observation conducted on 8-28-25, it was revealed that various rooms in memory care were missing soap and toothpaste products necessary for maintenance of proper hygiene. Additionally, it was observed on 8-28-25, that resident in room #8 was not provided an electric razor despite request and observed to be in need of grooming. LPM also observed various residents not groomed properly within memory care unit. As a result, the preponderance of evidence standard is met and this allegation is SUBSTANTIATED.

Allegation: Facility staff do not ensure that the resident bed is working. LPA conducted observation on 8-28-25 and observed bed in room #3 to not be operating properly. Specifically, foot of bed will raise, and head of bed would not raise. It was revealed through interview that bed currently in room #3 was placed in room after hospice company picked up a bed previously in the room. Additionally, it was observed by LPM that room #55 contained an air mattress for a resident which was not functioning properly. As a result, the preponderance of evidence standard is met and this allegation is SUBSTANTIATED.

Allegation: Facility staff denied residents going on outings . LPA conducted interviews and record reviews as noted above. Based on interviews and record reviews, it was revealed that on 7-28-25, staff5 (S5) disclosed to a family member via email that per Power of Attorney (POA), family member "cannot take {resident1 (R1)} anywhere." It was further revealed that R1 maintains his rights to visitation with family of choice. As a result, the preponderance of evidence standard is met, and this allegation is SUBSTANTIATED.

As a result of this investigation, citations are issued under Title 22, Division 6 and noted on LIC 9099D. An exit interview was conducted with licensee designee and a copy of this report was provided. Appeal rights and LIC 811 provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
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 6
Control Number 27-AS-20250729152109
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
09/11/2025
Section Cited
CCR
87303(a)
1
2
3
4
5
6
7
87303 Maintenance and Operation. (a) The facility shall be clean, safe, sanitary and in good repair at all times...This requirement was not met as evidenced by: Based on observation and interviews, licensee did not ensure cleanliness of various rooms. This posed a potential health and safety risk to resident
1
2
3
4
5
6
7
Licensee will develop and submit a plan ensuring on-going cleanliness of rooms throughout facility. Plan to include checklist of items and reviewed by Administrator for accruracy and completeness. Plan to be submitted to LPA by POC due date.
Type B
08/29/2025
Section Cited
CCR
87307(a)(3)
1
2
3
4
5
6
7
87307 Personal Accommodations and Services. (a) Living accommodations and grounds shall be related to the facility's function...(3) Equipment and supplies necessary for personal care and maintenance of adequate hygiene practice shall be readily available to each resident. This requirement was not met as evidence by:
1
2
3
4
5
6
7
Licensee will develop and submit a plan ensuring the proper availability of hygiene supplies for residents in care. Plan to be submitted to LPA by POC due date.
Licensee to ensure soap and other hygiene items are available in resident rooms by POC due date.
8
9
10
11
12
13
14
Based on observation, Licensee did not ensure necessary hygiene supplies were available to resident in care. This posed a potential health and safety risk to residents in care.
8
9
10
11
12
13
14
Type B
09/04/2025
Section Cited
CCR
87468.1(a)(2)
1
2
3
4
5
6
7
87468.1 Personal Rights of Residents in all facilities. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidence by: Based on observation and interview, bed in room #3 is not functioning properly, and air mattress in room #55 is not functioning properly. This posed a potential health and safety risk to residents in care.
1
2
3
4
5
6
7
Licensee will repair or replace bed and submit photo proof to LPA by POC due date. Licensee will repair or replace air mattress and send photo proof to LPA by POC due date.
Licensee will develop and submit a plan ensuring the functionality of resident equipment. Plan to be submitted to LPA by POC due date.
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: 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: 3 of 6
Control Number 27-AS-20250729152109
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
09/11/2025
Section Cited
CCR
87468.1(a)(1)
1
2
3
4
5
6
7
87468.1 Personal Rights of Residents in all facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1)To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee and designee will read regulation 87468.1(a)(1) and submit a signed declaration to LPA by POC due date.
8
9
10
11
12
13
14
Based on interview and written evidence, facility staff attempted to stop a desired outing for R1 and R1's family member. This posed a potential health, safety, and resident rights risk to residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 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: 4 of 6
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
07/29/2025 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20250729152109

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: 76DATE:
08/28/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:licensee designee Merylyn Oltero TIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff do not ensure that residents have clean linen
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8-28-25 at 10:00am, Licensing Program Analyst (LPA) Michael Bilger and Licensing Program Manager (LPM) Liza King arrived unannounced to deliver findings for the allegation noted above. LPA and LPM met with licensee designee Merylyn Oltero and explained the purpose of the visit. During the course of this investigation, LPA conducted interviews with five staff members and conducted facility observations on 8-6-25 and 8-28-25. Based on interviews and observations, it was revealed that facility maintains regular supply and sufficient amount of linens including bed sheets, pillow cases, towels, and other similar items available for residents use. LPA did not observe shortages of supplies. As a result, there is not a preponderance of evidence to conclude facility staff do not ensure clean linens for residents, 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 licensee designee 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: 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: 5 of 6