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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502701180
Report Date: 04/14/2026
Date Signed: 05/08/2026 10:50:55 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
02/09/2026 and conducted by Evaluator Noel Wolf Petersen
COMPLAINT CONTROL NUMBER: 27-AS-20260209084335
FACILITY NAME:COGIR OF TURLOCKFACILITY NUMBER:
502701180
ADMINISTRATOR:HERNANDEZ, JACKIEFACILITY TYPE:
740
ADDRESS:3791 CROWELL ROADTELEPHONE:
(209) 664-9500
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:100CENSUS: 72DATE:
04/14/2026
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Jackie HernandezTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff are not showering residents
Staff are not ensuring that residents are adequately fed
INVESTIGATION FINDINGS:
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**This is an amended report, the report was ammened because the strength of the evidence collected supports a finding of unsubstantiated for the allegations rather than unfounded, meaning unlikely to have occured rather than proven definitively false. unsubstantiated lanugage was added and unfounded language was removed.**

Licensing Program Analyst Noel Wolf Petersen arrived to the facility to deliver findings of a complaint concerning the above allegations, Met with administrator/executive Director Jackie Hernandez to exlain the purpose of the visit.LPA's review of client records shower schedule revealed cleints are on schedule to recive a shower roughly 1 day every 3 days(or 2x per week). 3 Staff and 3 client interviews provided a consensus that shower schedule was roughly accurate and there is sufficent staffing to flex emergency showers, refused/delayed showers, and incontinence care showers on a shift as necessisary to the clients needs. Showers can be accomodated with floor staff if home health aides are not availible.
Continued on c page
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026
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 2
Control Number 27-AS-20260209084335
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: COGIR OF TURLOCK
FACILITY NUMBER: 502701180
VISIT DATE: 04/14/2026
NARRATIVE
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**This is an amended report, the report was amended because the strength of the evidence collected supports a finding of unsubstantiated for the allegations rather than unfounded, meaning unlikely to have occurred rather than proven definitively false. unsubstantiated language was added and unfounded language was removed.**

LPA's review of client records regarding meal refusals revealed clients are given multiple opporutnities to refuse the same meal. 3 staff and 3 client interviews provided a consensus that meals are generally satisfactory. The LPA Witnessed a Meal service(noonish), where the clients were given serving sizes appearing proportionate to 1/3 of the daily serving values from the nutritional guide.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

No citations issued. A copy of the report was read and given to the Administrator. exit interview conducted. appeal rights provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2