392701629-7-31-2026-27-AS-LKIG-DWLTSY-20260803145955

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701629
Report Date: 07/27/2026
Date Signed: 07/31/2026 10:39:25 AM

Unsubstantiated

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
06/30/2026 and conducted by Evaluator Charlie Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20260630101820

FACILITY NAME:	MARBELLA TRACY		FACILITY NUMBER:	392701629
ADMINISTRATOR:	LAL, PRIYA		FACILITY TYPE:	740
ADDRESS:	355 WEST GRANT LINE ROAD		TELEPHONE:	(209) 835-1000
CITY:	TRACY	STATE: CA	ZIP CODE:	95376
CAPACITY:	180	CENSUS: 102	DATE:	07/27/2026
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Priya Lal		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff are not ensuring resident's hygiene needs are met

INVESTIGATION FINDINGS:

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Unannounced complaint visit made out to this facility on 07/27/2026 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator Priya Lal. A brief interview was conducted with the facility designated Administrator at this time.
Current census was 102 residents.
The purpose of this visit was to deliver the findings from this investigation to this facility, and it's representative, at this time.
Based on a review of the forms and documents obtained during the course of this investigation, it was learned that upon R1's initial admission into this facility this resident did not opt to have this facility provide services related to bathing and showering. This service would have created an additional fee for the basic services that this facility would have had to provide but was declined by the resident and their responsible party at the time of initial admission.
It was learned that the resident was then deemed to be able to conduct and perform their own showers and bathing needs while living at this facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026

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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Control Number 27-AS-20260630101820

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: MARBELLA TRACY	FACILITY NUMBER: 392701629
	VISIT DATE: 07/27/2026

NARRATIVE

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It was learned that as time went on the facility resident, R1, did not independently perform any bathing or showering which led to issues surrounding R1's hygiene.
It was learned that this facility attempted to seek alternative avenues to get R1 to bathe and shower to no avail.
It was learned that the family and responsible parties for R1 were contacted and involved in order to get R1 to take better care of R1's hygiene needs, specifically showering and bathing to keep R1 cleaner. It was learned that R1 refused to shower or bathe even with the presence, and offered assistance, from family members.
After these failed attempts with facility staff and involvement of the family members, It was learned that this facility made the decision to take on the showering and bathing needs for the resident R1. A revised care plan was implemented where facility staff would have a set shower schedule for R1 and attempt to shower R1 on those designated dates and times.
It was learned that these attempts were still met with resistance from R1 and properly documented by attending facility staff.
It was learned that attempts to simply do a wipe down or sponge bath in R1's bed were all denied and met with resistance.
It was learned that the next step would be for this facility, and the responsible parties for R1, to inquire with a licensed medical professional to see if there were any types of medications or procedures that could be deployed to ease the anxiety around showering and the use of water for R1.

As a result of this investigation, this Department found the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated meant that although the allegation may have happened or was valid, there was not a preponderance of the evidence to prove that the alleged violation occurred.

There were no deficiencies observed or cited at this time.

Exit Interview

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2026

LIC9099 (FAS) - (06/04)

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