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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397005738
Report Date: 08/28/2024
Date Signed: 08/28/2024 04:23:03 PM

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
08/23/2024 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20240823115557
FACILITY NAME:INSPIRING CAREFACILITY NUMBER:
397005738
ADMINISTRATOR:WILLIAM PUCKETTFACILITY TYPE:
735
ADDRESS:2488 NATHANIEL STREETTELEPHONE:
(209) 951-2405
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:5CENSUS: 3DATE:
08/28/2024
UNANNOUNCEDTIME BEGAN:
12:57 PM
MET WITH:William PuckettTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Staff does not provide food of nutritious quality to residents in care
INVESTIGATION FINDINGS:
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On 8-28-24 at 12:57pm, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and investigate the complaint allegation noted above. LPA met with Administrator William Puckett and explained the purpose of the visit. During this investigation, LPA conducted interviews with Administrator, staff1 (S1), and resident1 (R1). LPA also reviewed facility file and additional documentation, and conducted a facility observation on 8-28-24.

Allegation: Staff does not provide food of nutritious quality to residents in care. LPA conducted interviews as noted above. LPA also reviewed licensee's shopping records for August and conducted a facility observation. LPA also reviewed previous written report from outside agency dated 8-22-24. Based on interviews and record reviews, it was revealed that facility has been providing adequate amounts of food including food which meets the regulatory nutritional guidelines including fruits and vegetables. Record review reveals an approximate weekly pattern of these food items purchased consistently. LPA observed food delivery of above items during visit. Based on review of facility's menu, it was revealed that food items on hand matched menu items {cont. on 9099C}
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024
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-20240823115557
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: INSPIRING CARE
FACILITY NUMBER: 397005738
VISIT DATE: 08/28/2024
NARRATIVE
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Interviews conducted revealed facility has been consistently providing nutritious meals to residents in care. Additionally, it was determined through interviews that residents exercise their choices on food preferences. As a result, the preponderance of evidence standard is not met and this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with William Puckett and a copy of this report was provided to William. Appeal rights provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3