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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392701576
Report Date: 10/29/2025
Date Signed: 11/12/2025 10:34:08 AM

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
10/21/2025 and conducted by Evaluator Kesha Lewis
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20251021094041
FACILITY NAME:CRYSTAL CREEK SENIOR LIVINGFACILITY NUMBER:
392701576
ADMINISTRATOR:PUNNI,MANISHAFACILITY TYPE:
740
ADDRESS:2435 WAGNER HEIGHTS ROADTELEPHONE:
(209) 477-5353
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:80CENSUS: 67DATE:
10/29/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Deanna PosadaTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff not abiding by contract.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/12/25, Licensing Program Analyst (LPA) Kesha Lewis made an unannounced visit to this facility to Amed the report for the above allegations and met with Deanna Posada. LPA identified herself upon arrival, stated the purpose of the visit. LPA met with Angela Ringu and a brief interview followed.

LPA requested copies of the R1'S admissions agreement, LPA also interviewed and R1. Based on documents reviewed and interview with staff the above allegation is UNFOUNDED. The facility has no intention of moving R1 into a shared room, R1 has lived at the facility for 11 years in a private room and has not waived their right to a private room. The department has determined that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Exit interview and copy of report given.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Kesha Lewis
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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