079200855-10-21-2025-15-AS-BFOG-DN5U25-20251105141122

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079200855
Report Date: 10/21/2025
Date Signed: 10/21/2025 11:44:22 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 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
10/13/2025 and conducted by Evaluator Lori Alexander-Washington

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20251013135245

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: 143	DATE:	10/21/2025
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	David Clawson, Executive Director		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff does not ensure window coverings are in good repair in residents room

INVESTIGATION FINDINGS:

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On 10/21/2025, at 10:45 AM, Licensing Program Analyst (LPA), L. Alexander arrived unannounced conduct a 10-day initial complaint visit and deliver complaint findings for the allegation above. LPA met with David Clawson, Executive Director (ED), and explained the reason for the visit.

During the investigation LPA obtained copy of staff roster and resident roster. LPA tour the facility with ED, including but not limited to residents' apartments.

LIC9099-C Continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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-20251013135245

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
E BAY DELTA AC/SC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: TODOS SANTOS ASSISTED LIVING AND MEMORY CARE	FACILITY NUMBER: 079200855
	VISIT DATE: 10/21/2025

NARRATIVE

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LIC9099-C (Page 2)

Allegation: Staff does not ensure window coverings are in good repair in residents room
Finding: Unsubstantiated

On 10/21/2025 LPA L. Alexander interviewed Staff (S) and Resident (R). S1 stated that a few weeks ago R1 pulled the window blinds down and expressed that they didn't like the blinds which were hanging in their room. S1 stated that they decided to order curtains instead for R1's room and since then there hasn't been any issues. LPA observed that the window coverings including the curtain bracket that holds the curtain rod was secured and fasten. R2 was in the room and stated that the window coverings were replaced. R1 was not available during the visit.

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

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Lori Alexander-Washington
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC9099 (FAS) - (06/04)

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