397004353-10-4-2024-27-AS-LKIG-DA2NV5-20241014104719

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 397004353
Report Date: 10/04/2024
Date Signed: 10/04/2024 02:14:19 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
09/25/2024 and conducted by Evaluator Kesha Lewis

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20240925130041

FACILITY NAME:	ARBOR PLACE		FACILITY NUMBER:	397004353
ADMINISTRATOR:	BELINDA GUZMAN		FACILITY TYPE:	740
ADDRESS:	17 LOUIE AVE		TELEPHONE:	(209) 369-8282
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	76	CENSUS: 58	DATE:	10/04/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Belinda Guzman		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Facility door is not accesible to residents using mobility devices

INVESTIGATION FINDINGS:

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On 10-04-2024 at 1:00 PM, Licensing Program Analysts (LPA) Kesha Lewis conducted an unannounced facility visit to open a complaint investigation with the above allegation. LPA Lewis met with Belinda Guzman and explained the purpose of today's visit.

During today's visit, LPA Lewis reviewed title 22 regulations and the Ameracen with disabllities act and coucluded that nigther requires a facility to have remote opening doors for disabled persons. This agency has investigated the complaint allegation. This agency has found that the complaint was UNFOUNDED, meaning that the allegation were false, could not have happened and/or was without a reasonable basis.

An exit interview was conducted, and a copy of this report was given.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Liza King	TELEPHONE: (650) 676-0442
LICENSING EVALUATOR NAME: Kesha Lewis	TELEPHONE: (916) 764-1024
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2024

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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