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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 502701231
Report Date: 06/26/2025
Date Signed: 06/26/2025 10:56:00 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
06/25/2025 and conducted by Evaluator Renee Campbell
COMPLAINT CONTROL NUMBER: 27-AS-20250625120408
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:
06/26/2025
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Simrat Padda, CaregiverTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff engaged in a physical altercation with resident causing an injury.
INVESTIGATION FINDINGS:
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On 06/26/2025, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility unannounced regarding a complaint. LPA Campbell met with Simrat Padda, Caregiver and explained the purpose of the visit.

On May 28, 2025, it was reported that W1 threw soda cans at staff before being removed by police.
Regarding the allegation that staff engaged in a physical altercation with resident causing an injury on this same date, LPA Campbell interviewed W1 who stated that staff had hit them after W1 threw a can of soda at staff. LPA Campbell then interviewed two staff members (W3 and W4), a resident (W5) and the administrator (W2), accused of hitting W1. While W3 stated they had not directly seen W2 hit W1, W3 did report that they had never witnessed W2 ever hit any residents. W4 and W5 stated they directly witnessed W1 throw a can of soda and hit W2 in the leg but had not seen W2 hit W1.
Images of bruises on W1 were observed, but the source of the bruising is unclear as it may have resulted from W1 crawling out of the window.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
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 2
Control Number 27-AS-20250625120408
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: 06/26/2025
NARRATIVE
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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, Chapter 6, no deficiencies cited. Exit interview was held and a copy of report was given to Simrat Padda, Caregiver
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2