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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803815
Report Date: 11/25/2025
Date Signed: 11/25/2025 12:43:24 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/05/2025 and conducted by Evaluator Jill Nakagawa
COMPLAINT CONTROL NUMBER: 21-AS-20251105162512
FACILITY NAME:AMERICAN ASSISTED LIVINGFACILITY NUMBER:
486803815
ADMINISTRATOR:SUKHJIT SANDHUFACILITY TYPE:
740
ADDRESS:405 KINGS WAYTELEPHONE:
(510) 604-3825
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY:30CENSUS: 18DATE:
11/25/2025
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Anirudh Wadhwa, Acting AdministratorTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility does not have adequate staffing, resulting in residents’ needs not being met.
Facility staff do not provide activities for residents in care.
INVESTIGATION FINDINGS:
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On 11/25/2025 ,Licensing Program Analyst (LPA) Nakagawa arrived unannounced to deliver findings regarding the above allegation. LPA met with acting administrator, Anirudh Wadhwa.

The complaint alleges that Facility does not have adequate staffing resulting in residents’ needs not being met. LPA reviewed the staffing schedule for the last 30 days and found that there were 2-3 care staff per shift plus one cook scheduled for 17 residents. Upon review of time clock entries there were at least 2 care staff per shift on11/10/25. In addition, the acting administrator stated he was on site .from 10:00 AM to 2:00 PM.


Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
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 21-AS-20251105162512
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: AMERICAN ASSISTED LIVING
FACILITY NUMBER: 486803815
VISIT DATE: 11/25/2025
NARRATIVE
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....Continued from 9099

Interview with outside party stated they were told by staff member that other scheduled staff member was not due to arrive for another hour, however that was for a third caregiver. According to review of Time cards, there were two caregivers on site, and the third caregiver arrived for their shift at 3:50 PM. Based on review of time cards the allegation that Facility does not have adequate staffing resulting in residents’ needs not being met is unsubstantiated.Although the allegation may have occurred there is not a preponderance of evidence therefore the allegation is unsubstantiated.

The complaint alleges that Facility staff do not provide activities for residents in care. The Reporting Party (RP) indicated that the residents have not participated in any activities for the past several weeks. The RP did not provide any further information before disconnecting the call. LPA Nakagawa interviewed 3 residents able to communicate of the 17, regarding activities. They stated there were activities. Two of the three stated they preferred not to participate. LPA also interviewed a visiting family member who stated that the facility conducted activities at varying times. During visits on 6/19/2025 and 11/07/2025, LPA Nakagawa observed residents involved in a limited number of activities like balloon toss and puzzles, and residents were observed to be socializing and interacting during meals. LPA also observed an Activities Calendar. When asked about some of the activities listed, the acting administrator stated that one of the hospice agencies provided bible study on the weekends as well as music. LPA found there are no activities going on continuously, but the facility staff does provide a limited number of activities for the residents. Based on observations and interviews the allegation that Facility staff do not provide activities for residents in care is unsubstantiated. Although the allegation may have occurred there is not a preponderance of evidence therefore the allegation is unsubstantiated.


Continued on 9099-C
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
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: 2 of 3
Control Number 21-AS-20251105162512
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: AMERICAN ASSISTED LIVING
FACILITY NUMBER: 486803815
VISIT DATE: 11/25/2025
NARRATIVE
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Continued from 9099-C...

No citations issued.

Exit interview conducted with Acting Administrator, Aniruda Wadhwa.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
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