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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700941
Report Date: 11/12/2025
Date Signed: 11/25/2025 11:24:08 AM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH 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
11/06/2025 and conducted by Evaluator Noel Wolf Petersen
COMPLAINT CONTROL NUMBER: 27-AS-20251106161445
FACILITY NAME:CHIANTI GRACE, LLCFACILITY NUMBER:
392700941
ADMINISTRATOR:LAUREL, MARICARFACILITY TYPE:
740
ADDRESS:9063 CHIANTI CIRCLETELEPHONE:
(209) 688-8058
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:6CENSUS: 6DATE:
11/12/2025
UNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Maricar LaurelTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident sustained unexplained injuries
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
**This report is ammended to better clarify the evidence used to determine the outcome of UNFOUNDED**
Licensing Program Analyst, LPA, Noel Wolf Petersen arrived unannounced to the facility to open a complaint regarding a resident staying at Chianti Grace. The LPA met with the administrator Maricar Laurel to explain the purpose of the visit.
LPA attempted to interview the resident, they were lounging comfortably, the bruising appears to be subsided. According to the Reporting party the bruising was observed on 10/28/25 during a routine visit at the residents previous residence. According to the responsible person the incident was reported by the reporting party whom visited the resident at the residents last known address prior to moving into the current facility. According to the admissions agreement and interview with Administrator the resident moved into the current facility on 10/31/2025.
Therefore, the resident sustained the injuries on10/28/25 before moving into this facility on 10/31/25. The resident was not physically present at the current facility.
This agency has investigated the complaint allegation. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Noel Wolf Petersen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
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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