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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397005571
Report Date: 11/25/2025
Date Signed: 11/26/2025 07:46:06 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
08/14/2025 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250814132201
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: 32DATE:
11/25/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:A WalshTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Licensee does not ensure that resident's receive medical services as necessary.
Licensee does not ensure that there are Restricted Health Condition Care Plans for residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Albert Johnson and Jason Lund arrived unannounced to deliver findings.

Allegation: Licensee does not ensure that resident's receive medical services as necessary.

R1 has received labs on 9/20/2025. The facility has a medical plan dated 7/11/2025 confirming the need to have labs for the following blood tests: Complete blood count, thyroid function tests (TSH), clozapine level, and a complete metabolic panel. This has been completed the last labs for R1 were conducted on 9/20/2025. The allegation is Unsubstantiated.
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
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
Control Number 27-AS-20250814132201
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
VISIT DATE: 11/25/2025
NARRATIVE
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Allegation: Licensee does not ensure that there are Restricted Health Condition Care Plans for residents in care.

Based on records reviewed, LPA was able to determine that R1 has a current restricted healthcare plan dated 7/25/2025. The department was unable to determine if all residents prior to the dates reviewed were using and had current restricted healthcare plans. The allegation is unsubstantiated.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3