079200855-2-26-2026-15-AS-HHUL-DRUUE9-20260304143047

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 079200855
Report Date: 02/26/2026
Date Signed: 02/26/2026 02:11:38 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
08/29/2025 and conducted by Evaluator Jill Clancy-Czuleger

COMPLAINT CONTROL NUMBER: 15-AS-20250829120512

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: 148	DATE:	02/26/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Joseph Dungo, Community Relations Director		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff overcharged a resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 2/26/2026 at 1:00PM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger arrived unannounced to deliver findings for the above allegations. LPA explained the purpose of the visit with PA met with Joseph Dungo, Community Relations Director. Administrator David Clawson was informed of the visit.

On the allegation: Staff overcharged a resident
Based on records review and interviews R1 was originally assesed at level 3 of care, but R1's POA had a disscution with the previous mangment to move R1 down to level 2. This was not properly documented and R1 was continuing to be charged at the higer rate.

Based on LPA’s interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 has been cited.

Exit interview conducted. A copy appeal rights, and this report provided.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026

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 3

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
08/29/2025 and conducted by Evaluator Jill Clancy-Czuleger

COMPLAINT CONTROL NUMBER: 15-AS-20250829120512

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: 148	DATE:	02/26/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Joseph Dungo,		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff not following the terms in the residents’ Admission Agreement

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 2/26/2026 at 1:00PM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger arrived unannounced to deliver findings for the above allegations. LPA explained the purpose of the visit with PA met with Joseph Dungo, Community Relations Director. Administrator David Clawson was informed of the visit.

On the allegation: Staff not following the terms in the residents’ Admission Agreement
Based on interviews and record reviews R1’s admissions agreement did not state if they were in a shared or private room. S1 said that it may have been verbally stated to R1 or their responsible party with the previous management, but when the new management took over at the beginning of 2025, they had no documentation to confirm this claim.

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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Jill Clancy-Czuleger
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 15-AS-20250829120512

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: 02/26/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/26/2026 Section Cited CCR 87464(f)(1)	1 2 3 4 5 6 7	(f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement was not met as evidence by:	1 2 3 4 5 6 7	The administrator corrected R1's billing and documentation to show that R1 was level 2 instead of level three and retroactivly paid back the over charged amount to R1. POC is cleared
	8 9 10 11 12 13 14	Based on interviews and record reviews the Licensee did not comply with the section cited above in charging R1 for a higher level of services than they were in.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: 02/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2026

LIC9099 (FAS) - (06/04)

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