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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 079200855
Report Date: 01/05/2026
Date Signed: 01/05/2026 03:05:29 PM

Substantiated


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
08/22/2025 and conducted by Evaluator Jill Clancy-Czuleger
COMPLAINT CONTROL NUMBER: 15-AS-20250822084705
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: DATE:
01/05/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:David Clawson, AdministratorTIME COMPLETED:
03:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Uncleared staff are providing care and supervision to residents in care
Staff are not ensuring that residents' hygiene needs are being met while in care
Staff are not ensuring that residents are administered their medications as necessary.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 01/05/2026, Licensing Program Analysts (LPA), J. Clancy-Czuleger arrived unannounced to deliver complaint findings for the above allegations. LPA met with David Clawson, Administrator and explained the reason for the visit.During the course of investigation, LPA obtained information, collected documents and interviewed staff and residents.

On the allegation: facility Uncleared staff are providing care and supervision to residents in care.

Based on record review and interviews, on 08/28/2025 the facility had four staff (S4, S5, S6, and S7) scheduled to work on the staff schedule that were not associated to the facility. On 01/05/2026 S5 and S6 ares still not associated and S4 is not fingerprint cleared or background checked. S7 was associated the the facility on 10/02/2025.

Continued on LIC 9099C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
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 6
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
08/22/2025 and conducted by Evaluator Jill Clancy-Czuleger
COMPLAINT CONTROL NUMBER: 15-AS-20250822084705

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: DATE:
01/05/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:David Clawson, AdministratorTIME COMPLETED:
03:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee is not ensuring that staff follow proper infection control practices.
Staff did not ensure that resident received medical attention as needed.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 01/05/2026, Licensing Program Analysts (LPA), J. Clancy-Czuleger arrived unannounced to deliver complaint findings for the above allegations. LPA met with David Clawson, Administrator and explained the reason for the visit.During the course of investigation, LPA obtained information, collected documents and interviewed staff and residents. During the course of investigation, LPA obtained information, collected documents and interviewed staff and residents.

On the allegation facility Staff did not ensure that resident received medical attention as needed. Based on record review and interviews the facility staff will call 911 for any medical situation they observed or anytime a resident request 911 to be called. S8 stated that when residents need assistance with turning at night or other routine smaller medical needs the staff all work together to prioritize those ADL’s even when short staffed. S8 said they have not heard or seen other staff denying residents requests with ADL’s or medical needs.
Continued on 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 15-AS-20250822084705
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: 01/05/2026
NARRATIVE
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5
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7
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On the allegation facility Licensee is not ensuring that staff follow proper infection control practices
Based on record review and interviews the facility had been submitting incident reports for facility residents who were testing positive with Covid. S1 stated that they had staff who were out sick who either did not test positive that were out for other illnesses or had not tested for covid.

Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 15-AS-20250822084705
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/05/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/07/2026
Section Cited
CCR
87355(e)(2)
1
2
3
4
5
6
7
Criminal Record Clearance. All individuals subject to a criminal record review... Obtain a California clearance...as required by the Department... This requirement is not met as evidence by:
1
2
3
4
5
6
7
Facility has agreed to obtain fingerprint clearance S4. House manager will submit a plan to obtain fingerprint clearance for S4 by POC date.
8
9
10
11
12
13
14
Based on record review, licensee did not comply with the section cited above by not having one staff fingerprint cleared which poses an immediate health and safety risk to the persons in care.
8
9
10
11
12
13
14
Type B
01/12/2026
Section Cited
CCR
87355(e)(3)
1
2
3
4
5
6
7
Criminal Record Clearance. All individuals subject to a criminal record review...Request a transfer of a criminal record clearance... This requirement is not met as evidence by:
1
2
3
4
5
6
7
S7 has been associated to the facility. The facility has agreed to associate S5 and S6 to the facility and submit proof of association by POC date.
8
9
10
11
12
13
14
Based on record review, licensee did not comply with the section cited above by not having two staff associated to the facility which poses a potential health and safety risk to the persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 15-AS-20250822084705
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/05/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/07/2026
Section Cited
CCR
87465(a)(2)
1
2
3
4
5
6
7
(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall... by compliance with the following:(2)The licensee shall provide assistance in meeting necessary medical and dental needs...
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee to review facility's procedure in ordering medication refill. Proof to be submitted by 01/07/2026
8
9
10
11
12
13
14
The facility staff did not call for refill in timely manner which resulted in residents missing medication dosages. This poses an immediate health risk to resident in care.
8
9
10
11
12
13
14
Type B
01/06/2026
Section Cited
CCR
87411(a)
1
2
3
4
5
6
7
Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs....
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The facility has sence hired addtional staff in all departments.
8
9
10
11
12
13
14
The facility not having enough staff at that time to preform all resident ADL's
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 15-AS-20250822084705
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: 01/05/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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23
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25
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27
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31
32
On the allegation: facility Staff are not ensuring that residents' hygiene needs are being met while in care.

Based on record review and interviews, the facility did not have enough staff at that time, staff interviewed stated that they felt like they could not keep up with resident ADL's with the number of staff that they had. S3 stated that they would be barely enough staff scheduled to work and then people would call off and there was no one to cover for them.

On the allegation facility staff are not ensuring that residents are administered their medications as necessary. Based on record review and interviews when residents were moving into the facility they were not coming in with a full/mostly full prescription of medications. S2 stated that residents/residents responsible parties were informed that they should be moving in with full/mostly full prescriptions so the facility would have time to get their prescriptions transfers and any authorizations approved before a resident would run out of medication.

Based on LPAs interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), is being cited on the attached LIC 9099D.

Exit interview conducted. Appeal Rights and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6