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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200855
Report Date: 12/19/2025
Date Signed: 12/19/2025 11:33:36 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 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
10/20/2025 and conducted by Evaluator James Sampair
COMPLAINT CONTROL NUMBER: 15-AS-20251020102235
FACILITY NAME:TODOS SANTOS ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
079200855
ADMINISTRATOR:CLAWSON, DAVID JFACILITY TYPE:
740
ADDRESS:1081 MOHR LNTELEPHONE:
(925) 798-3900
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY:160CENSUS: 146DATE:
12/19/2025
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Memory Care Manager Joseph DungoTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Staff did not follow residents care plan resulting in severe malnurishment and dehydration.
Staff do not ensure facility is free of mal odors.
Staff do not ensure facility is kept in good repair.
INVESTIGATION FINDINGS:
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On 12/19/2025 at 10:15 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to deliver findings on the allegations above. The LPA informed Memory Care Manager Joseph Dungo of the reason for the visit.

The Department's investigation included, but was not limited to, interviews with staff and a review of the records pertaining to Resident R1, which included facility records and medical records. The Department also inspected the facility, interviewed staff, and reviewed facility maintenance records.

The complaint alleges that staff did not follow resident’s care plan resulting in severe malnourishment and dehydration.
According to a review of Resident R1’s medical records, there was no indication that R1 suffered from dehydration or malnourishment while a resident at the facility. The medical records do not support the allegation.

Continued on LIC 9099 . . .
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
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 15-AS-20251020102235
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: TODOS SANTOS ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 079200855
VISIT DATE: 12/19/2025
NARRATIVE
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. . . Continued from LIC 9099

The complaint alleges that staff do not ensure facility is free of mal odors.
The LPA visited the facility and directly observed Room 104, where R1 lived while at the facility. The LPA also inspected the patio drain just outside of Room 104, where the malicious odors were alleged to have originated. The LPA did not smell any malicious odors, and the facility records showed no previous complaints of odors. The review of the records and direct observations by the LPA do not support the allegation.

The complaint alleges that staff do not ensure facility is kept in good repair.
The LPA visited the facility and reviewed maintenance records. The LPA observed the facility being in full working order. The LPA’s record review showed that regular maintenance is being conducted at the facility. The LPA’s observations and review of the records do not support the allegation.

Although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove them; therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2