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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 397005719
Report Date: 11/30/2021
Date Signed: 11/30/2021 11:28:30 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/23/2021 and conducted by Evaluator Michael Bilger
COMPLAINT CONTROL NUMBER: 27-AS-20211123110557
FACILITY NAME:DIGNA'S CARE HOME #1FACILITY NUMBER:
397005719
ADMINISTRATOR:CABRERA, DIGNAFACILITY TYPE:
735
ADDRESS:2955 CHRISTINA AVETELEPHONE:
(209) 598-7588
CITY:STOCKTONSTATE: CAZIP CODE:
95204
CAPACITY:6CENSUS: 6DATE:
11/30/2021
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Digna CabreraTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility has pests
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11-30-21 at 10:10am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to open and conduct an investigation for the allegation listed above. LPA met with Administrator Digna Cabrera and explained the purpose of the visit. During this investigation, LPA interviewed Administrator and S2. LPA also interviewed Resident1 (R1). LPA observed facility inside and out including all common areas, all resident bedrooms, kitchen area, kitchen cabinets, medication cabinets, window seals in common areas, resident bedrooms, and common areas. LPA also observed all bathrooms, and food storage areas. Based on observations, facility appeared clean and sanitary with no foul odors. LPA did not observe any roaches or other insects, or evidence of insects. Based on interview with S2, facility is cleaned once per day. Based on interview with Administrator, facility has an ongoing pest control service in place. LPA observed email communication from Administrator to pest control service confirming agreement for once per month treatment.

Based on observation and interviews, it is determined that this allegation is UNSUBSTANTIATED. An exit interview was conducted with Digna Cabrera and a copy of this report was left with Digna.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Michael BilgerTELEPHONE: 916-862-4722
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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