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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397002232
Report Date: 07/13/2026
Date Signed: 07/14/2026 02:57:56 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
04/29/2026 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260429141929
FACILITY NAME:DE ORO GUEST HOME #2FACILITY NUMBER:
397002232
ADMINISTRATOR:DORIS B MADRIDFACILITY TYPE:
735
ADDRESS:1648 KNICKERBOCKER COURTTELEPHONE:
(209) 670-4458
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:6CENSUS: 4DATE:
07/13/2026
UNANNOUNCEDTIME BEGAN:
09:48 AM
MET WITH:N. Van De PolTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility staff do not keep facility clean
Facility staff do not allow a comfortable environment
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) conducted an unannounced complaint investigation visit to deliver findings. LPA met with Licensee. LPA explained the purpose of the visit.

Based on interviews, observations, and records reviewed, the allegations that
Facility staff do not keep the facility clean, and Facility staff do not allow a comfortable environment are substantiated.

Administrator stated the facility “is cleaned regularly,” but acknowledged “there are days when stuff falls behind.” Administrator denied pest issues and stated toilet paper is “always stocked.” Administrator stated they “try to be available” to open the door but acknowledged “there may be delays.” Resident's acknowledged inconsistent cleaning. RP and resident reports described clutter and mess but they know where things are. Cleaning logs are not used. RP reported clutter, worn furniture, and inconsistent cleanliness contributing to discomfort.

The allegations are substantiated.

Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
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 3
Control Number 27-AS-20260429141929
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: DE ORO GUEST HOME #2
FACILITY NUMBER: 397002232
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
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Type B
07/20/2026
Section Cited
CCR
80087(a)
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Buildings and Grounds. The facility shall be kept clean, sanitary and in good repair at all times. LPA observed Front yard and Backyard needs debris to be removed, and an old couch.
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Licensee did remove broken Furniture, Couches and repaired the fences
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 This poses a health and safety risk to residents in care.
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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.
SUPERVISOR'S NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
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
04/29/2026 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20260429141929

FACILITY NAME:DE ORO GUEST HOME #2FACILITY NUMBER:
397002232
ADMINISTRATOR:DORIS B MADRIDFACILITY TYPE:
735
ADDRESS:1648 KNICKERBOCKER COURTTELEPHONE:
(209) 670-4458
CITY:STOCKTONSTATE:CAZIP CODE:
95210
CAPACITY:6CENSUS: 4DATE:
07/13/2026
UNANNOUNCEDTIME BEGAN:
09:48 AM
MET WITH:N. Van De PolTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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9
Facility staff do not keep facility free of pests
Facility staff did not ensure they were available to enter the facility
Facility staff do not provide adequate toilet paper
Facility staff did not administer medication as prescribed
INVESTIGATION FINDINGS:
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No pests observed during current visits. Staff denied issues. No pest control records indicating recent concerns. Staff acknowledged occasional delays but no evidence of being unavailable when guest arrive. Inventory confirmed adequate supply of toilet paper. Administrator acknowledged R1 went to the urgent care 3/29/2026 and was taken by his mother the medications were given to him and not shared with the care home until R1 was unable to put the patch on and ask for assistance. The facility started the medication on 4/22/2026.

Based on interviews, observations, and records reviewed, the allegations that:
Facility staff do not keep the facility free of pests, Facility staff did not ensure they were available to enter the facility, and Facility staff do not provide adequate toilet paper. Facility staff did not administer medication as prescribed

UNSUBSTANTIATED.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3