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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 342700157
Report Date: 07/23/2025
Date Signed: 07/23/2025 02:41:13 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-20250709122929
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: 25DATE:
07/23/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Administrator, Maria Susie DizonTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff do not follow meal menu.
Staff provide inadequate meal service.
Staff provide inadequate supervision resulting in resident entering other residents’ rooms.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 07/23/25 to deliver complaint findings for the above allegations. LPA met with administrator, Maria Susie Dizon, and explained the purpose of the visit.

Throughout the course of the investigation the department did facility observations and conducted interviews with residents and staff relevant to the complaint allegation.



Report continued on LIC 9099-C....
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
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 59-AS-20250709122929
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CHALET, THE
FACILITY NUMBER: 342700157
VISIT DATE: 07/23/2025
NARRATIVE
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***Report continued from 9099.....
Allegation- Staff do not follow meal menu. Staff provide inadequate meal services. -UNFOUNDED

An investigation has been conducted regarding the above allegations. LPA observed the facility food supply as well as interviewed four residents regarding the food service. Based on observation and interviews, the facility keeps the required amount of food supply in the facility. Additionally, resident interviews indicated that residents are satisfied with the food service at the facility and feel that they have enough food to eat at every meal. During facility tour, LPA observed the food menu for residents in the common area. Four staff interviews reflected that residents were satisfied with meal services and residents can choose alternatives if they do not like the food items served in the regular menu. Based on this information, this allegation is UNFOUNDED.

Allegation- Staff provide inadequate supervision resulting in resident entering other residents’ rooms- UNFOUNDED

The Department reviewed records and conducted interviews with staff and residents to investigate this allegation. Four (4) residents interviews conducted on 07/14/25 indicated that residents care needs were met per their needs and service plans and there were no concerns. Resident’s interviews reflected that some residents can be challenging sometimes with other individuals but staff able to redirect them in a safe and professional manner. Residents’ interviews indicated that residents felt safe at the facility and were receiving good care from staff. Four (4) staff interviews conducted on 07/14/25 reflected that there were no concerns from any resident or family with resident’s care. Staff interviews indicated that sometimes residents would attempt to go to another resident’s rooms, not knowing their assigned room number but staff assist them to navigate to their room without any issues. Staff interviews did not identify any residents who were going to other residents rooms and did not express any concerns about this matter. Based on the information gathered, this allegation was found to be UNFOUNDED.

This agency has investigated this complaint. We have found the complaint was UNFOUNDED, meaning that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview was conducted with the Administrator and a copy of this report was provided to the facility. The signature of the Administrator on these forms acknowledges receipt of these documents.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2