079200855-10-10-2025-15-AS-HHUL-DMGV4H-20251015160621

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079200855
Report Date: 10/10/2025
Date Signed: 10/10/2025 01:20:21 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

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 Laura Hall

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20251007121849

FACILITY NAME:	TODOS SANTOS ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	079200855
ADMINISTRATOR:	CLAWSON, DAVID J		FACILITY TYPE:	740
ADDRESS:	1081 MOHR LN		TELEPHONE:	(925) 798-3900
CITY:	CONCORD	STATE: CA	ZIP CODE:	94518
CAPACITY:	160	CENSUS: 145	DATE:	10/10/2025
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	David Clawson, Executive Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff are not treating resident with dignity and respect

Staff are not providing adequate food service to resident

INVESTIGATION FINDINGS:

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On 10/10/2025, at 10:40am, Licensing Program Analyst (LPA), L. Hall arrived unannounced conduct a 10-day initial complaint visit and deliver complaint findings for the allegations above. LPA met with David Clawson, Executive Director, and explained the reason for the visit.

During the investigation LPA interviewed four (4) staff, seven (7) residents, obtained staff roster, resident roster, and a copy of the menu for the week.

Allegation: Staff are not treating resident with dignity and respect

During the investigation W1 stated at initial interview kitchen staff

Continued on LIC9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025

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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Control Number 15-AS-20251007121849

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: TODOS SANTOS ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 079200855
	VISIT DATE: 10/10/2025

NARRATIVE

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Continued from LIC9099.

discriminates against and is targeting her because she is not allowed to go to the kitchen. W1 stated there is a new rule that no one is allowed in the kitchen doorway or in hallway near the kitchen, but W1 has observed another residents there. S1 stated during interview that there has been a conversation about disrespect. S1 stated that kitchen staff was not being disrespectful but had to set a boundary regarding coming to the kitchen. S2, S3, and S4 stated during interview there are slips for residents to fill out if they do not want what is being served. The kitchen request the slip are put in approximately 1-hour before mealtime in order to accommodate. S2 stated when the staff is preparing for meals there isn't time to stop and accommodate one or two residents at that exact time. Six (6) of the residents stated the staff treats them well and with respect.

Allegation: Staff are not providing adequate food service to resident

During initial interview W1 stated staff is not heating up residents' food that is bought by them personally. LPA observed a food delivery during the visit. LPA also reviewed the facility menu for the week of October 5, 2025 to October 11, 2025. During visit LPA observed kitchen staff cooking and serving what was on the menu along with other items. S2 stated there is a main menu and an alternate menu for residents. S2 also stated if a resident wants food heated it is not a problem just not when the kitchen is in full working mode. S2 request residents to ask before the kitchen is preparing meals or after the residents are served. Six (6) of the seven (7) residents interviewed stated if they do not want what is being the served the kitchen does their best to accommodate them.

Based upon the information obtained during investigation and the interviews conducted. The above allegations are unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025

LIC9099 (FAS) - (06/04)

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