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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397005571
Report Date: 08/15/2025
Date Signed: 08/18/2025 10:50:27 AM

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
05/13/2025 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250513161533
FACILITY NAME:ENCLAVE AT THE DELTAFACILITY NUMBER:
397005571
ADMINISTRATOR:LO, SUSANFACILITY TYPE:
735
ADDRESS:4951 EIGHT MILE ROADTELEPHONE:
(209) 210-4863
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:45CENSUS: 39DATE:
08/15/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Tia PrestonTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff mismanaged client's funds
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Albert Johnson conducted a facility visit to deliver findings for the above allegations.

Allegation: Staff mismanaged client's funds. Records reviewed confirmed that the allegation is substantiated, the facility's record of client/resident 's safeguarded cash resources form includes withdrawn amounts shown twice for the same amount ($45.11) for on-line shopping; one dated 2/22/2025 and the other is without a date labeled as "online order money pulled ($45.11)" and the wrong amount carried over ($282.74) for 2/20/2025 cash on hand. Based on this information the balances for the period of 2/20/2025 through 6/12/2025 are not settled.

The allegation is substantiated.

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

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
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 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
05/13/2025 and conducted by Evaluator Albert Johnson
COMPLAINT CONTROL NUMBER: 27-AS-20250513161533

FACILITY NAME:ENCLAVE AT THE DELTAFACILITY NUMBER:
397005571
ADMINISTRATOR:LO, SUSANFACILITY TYPE:
735
ADDRESS:4951 EIGHT MILE ROADTELEPHONE:
(209) 210-4863
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:45CENSUS: 39DATE:
08/15/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Tia PrestonTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide privacy accommodations to client in care
Staff did not maintain the facility premises free of pests
Facility is not equipped with a working telephone for clients' use.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Allegation: Staff did not provide privacy accommodations to client in care. Based on interviews conducted and observation the facility does provide residents with a reasonable level of personal privacy with telephone conversations, accommodations for visits with family/case managers or with use of the internet.

Allegation: Staff did not maintain the facility premises free of pests. Based on records reviewed and observation the department confirmed that the facility is in an ongoing contracted with a pest control agency. The facility has addressed the pest issue with the pest control agency. The department was unable to confirm or deny that the facility premises were with pest on the date of the reported allegation. As a result the department finds that the allegation is unsubstantiated.

Allegation: Facility is not equipped with a working telephone for clients' use. The facilities' phone was not operational for a short period of time and as a result the residents used a cell phone provided by the facility for use while the phone was being repaired. The department confirmed this information from staff during the investigation. Staff reiterated that the residents did not go without a means of communication at anytime. As a result the department finds that the allegation is unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2025
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
Control Number 27-AS-20250513161533
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: ENCLAVE AT THE DELTA
FACILITY NUMBER: 397005571
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
08/29/2025
Section Cited
CCR
80026(h)(1)(A)
1
2
3
4
5
6
7
(h) Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following: (1) Records of clients' cash resources maintained as a drawing account, which shall include a current ledger accounting, with columns for income, disbursements and balance, for each client. Supporting receipts for purchases shall be filed in chronological order. (A) Receipts for cash provided to any client from his/her account(s) shall include the client's full signature or mark, or authorized representative's full signature or mark, and a statement acknowledging receipt of the amount and date received, as follows: "(full signature of client) accepts (dollar amount) (amount written cursive), this date (date), from (payor)."
1
2
3
4
5
6
7
The facility will complete an internal audit of R1's cash resources for the period of January 2025 through August of 2025.
8
9
10
11
12
13
14
This requirement is not met as evidenced by resources form includes withdrawn amounts shown twice for the same amount ($45.11) for on-line shopping; one dated 2/22/2025 and the other is without a date labeled as "online order money pulled ($45.11)" and the wrong amount carried over ($282.74) for 2/20/2025 cash on hand.
8
9
10
11
12
13
14
The updated LIC 405 (cash resources) and LIC 621 (personal property) will be completed an sent to the department by close of business on the POC date of 8/29/2025.
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: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3