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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700157
Report Date: 07/14/2025
Date Signed: 07/14/2025 12:14:37 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/09/2025 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20250709104444
FACILITY NAME:CHALET, THEFACILITY NUMBER:
342700157
ADMINISTRATOR:SUSIE DIZONFACILITY TYPE:
740
ADDRESS:6487 MAIN STREETTELEPHONE:
(925) 787-2740
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:41CENSUS: 26DATE:
07/14/2025
UNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Administrator, Maria Susie DizonTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not ensure facility elevator is in good repair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 07/14/25, Licensing Program Analyst (LPA) Talwinder Bains arrived at the unannounced to do complaint investigation into the allegation listed above and met with administrator, Maria Susie Dizon and explained the reason of today's visit.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation. Based on interviews and records reviewed, the elevator broke on 07/09/25 and facility reached out same day to company who will repair it. Per facility records and interviews, repair company ordered the broken part and elevator was fully fixed on 07/22/25. Although the elevator was temporarily not in service, the plan to get residents downstairs was implemented and therefore the allegation is unfounded, as there was no harm caused to residents in care. Therefore, the allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Exit interview was conducted with administrator and a copy of this report was provided to the facility.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2025
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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