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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 486803815
Report Date: 10/22/2025
Date Signed: 10/22/2025 01:36:49 PM

Substantiated


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
10/07/2025 and conducted by Evaluator Jill Nakagawa
COMPLAINT CONTROL NUMBER: 21-AS-20251007163433
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: 17DATE:
10/22/2025
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Sukhjit Sandhu, Licensee/AdministratorTIME COMPLETED:
11:36 AM
ALLEGATION(S):
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Unlawful Eviction
Facility did not meet residents needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nakagawa and Licensing Program Manager (LPM) Mota met with Licensee Sukhjit Sandhu during an office visit at the Santa Rosa Regional Office on October 22, 2025 and delivered findings on this complaint. During the course of this investigation, this Department has reviewed documents and taken witness and Licensee statements. The following determinations are made: R1 was admitted to a medical facility on 09/17/2025 due to a fall at the facility. On or about 10/3/2025, R1 was medically cleared for release and R1's care facility was notified.

Continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
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-20251007163433
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: 10/22/2025
NARRATIVE
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Continued from 9099....

On 10/3/2025, in conversation with medical social worker, care facility staff indicated refusal to accept R1 back into the care facility due to a change of condition and lack of payment. Licensee stated in the meeting of 10/22/25 “an eviction letter was not provided to R1”. R1 currently remains at the medical facility although medical facility has confirmed R1 is able to be discharged. In addition, Licensee states R1 had a change in condition which R1 was not reassessed for.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 66 & Chapter number), are being cited on the attached LIC 9099D.

Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 21-AS-20251007163433
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/23/2025
Section Cited
CCR
87224(a)
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87224 Eviction Procedures:87224 (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required. This requirement was not met as evidenced by:
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LIcensee will provide a plan to bring back resident R1 and address R1's need for a higher level of care by 10/23/2025.
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Based on LPAs observations and interviews which were conducted and record review(s),the Licensee did not follow the 30-day notice for an eviction which poses an immediate health, safety or personal rights risk to persons in care.
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Type B
11/04/2025
Section Cited
CCR
87463(b)(1)(C)
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Reappraisals:(b)The reappraisal shall document significant changes...
(1) Significant changes in condition...(C)Behavioral expression, as hazard awareness, or lacking in impulse control. This requirement is not met as evidenced by:
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Licensee to provide CCL with an updated LIC601 and Reappraisal by 11/04/2025.
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*Based on interviews the licensee didn't comply with this section when R1 had a change in condition and was not reassessed which poses a potential risk to residents in care.
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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: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3