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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502701231
Report Date: 10/08/2024
Date Signed: 10/18/2024 12:29:13 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
06/21/2024 and conducted by Evaluator Renee Campbell
COMPLAINT CONTROL NUMBER: 27-AS-20240621082405
FACILITY NAME:SHELTERING ARMS LLCFACILITY NUMBER:
502701231
ADMINISTRATOR:DHILLON, JATINDERFACILITY TYPE:
735
ADDRESS:3401 PUMA WAYTELEPHONE:
(209) 920-4494
CITY:CERESSTATE: CAZIP CODE:
95307
CAPACITY:4CENSUS: 3DATE:
10/08/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Navneet Kaur, Direct Service ProviderTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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 Staff do not provide an adequate quantity of food to residents in care.
INVESTIGATION FINDINGS:
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On 10/08/24, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility regarding a complaint. LPA Campbell was met by Navneet Kaur, Direct Service Provider, and explained the purpose of the visit.

Regarding the allegation that Staff do not provide an adequate quantity of food to residents in care, LPA conducted interviews and reviewed monthly menus..

Of the three clients residing in the facility, two were interviewed. R1 and R2 reported that they had an adequate amount of food and were able to ask for and receive additional servings upon request. When interviewed, R2 stated the only time they missed a meal it was due to being late for day program. However, R2 also stated, “they always ask me if I want to stay and eat first”. Monthly menus are used by the facility on a rotational basis but are subject to change based on the requests of residents.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024
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 2
Control Number 27-AS-20240621082405
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: SHELTERING ARMS LLC
FACILITY NUMBER: 502701231
VISIT DATE: 10/08/2024
NARRATIVE
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Based on all the information collected by the Department there is not a preponderance of evidence to prove the allegation occurred, therefore this allegation is UNSUBSTANTIATED. Due to the above noted information, 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, and therefore this allegation is unsubstantiated. Per California Code of Regulations (CCRs) - Title 22, Division 6, no deficiencies cited. Exit interview was held and a copy of report was given to Navneet Kaur, Direct Service Provider
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2