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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700993
Report Date: 09/22/2025
Date Signed: 10/02/2025 02:14:58 PM

Unsubstantiated


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
06/13/2025 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250613163526
FACILITY NAME:A1 DEL MONTE STOCKTONFACILITY NUMBER:
392700993
ADMINISTRATOR:SANDEEP SAINIFACILITY TYPE:
740
ADDRESS:517 E. FULTON STREETTELEPHONE:
(209) 910-5910
CITY:STOCKTONSTATE: CAZIP CODE:
95204
CAPACITY:158CENSUS: 158DATE:
09/22/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Sunny SainiTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff neglect resulted in a resident sustaining injuries while in care
Staff interfere with a resident's visitations
Staff are mishandling a resident while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Albert Johnson arrived at facility unannounced to deliver findings for the above listed allegations.

Allegation: Staff neglect resulted in a resident sustaining injuries while in care. Based on records reviewed and interviews conducted with the facility staff and R1, the facility is providing support for fall prevention as identified in the service plans reviewed from 2021 to present. R1 has a history of falls and is supported through out the day with transferring, and mobility as needed. The facility has provided R1 with updated services plans and continues to provide services to meet the needs of R1. The allegation is unsubstantiated.
Continued
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025
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 27-AS-20250613163526
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: A1 DEL MONTE STOCKTON
FACILITY NUMBER: 392700993
VISIT DATE: 09/22/2025
NARRATIVE
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Allegation: Staff interfere with a resident's visitations. The facility has reviewed the visiting hours with R1 as identified in the facility admission agreement and the facility handbook. The facility's visiting hours are from 8am to 8pm or by arrangement. R1 is sharing a room with another and the facility emphasizes courtesy and consideration while entertaining visitors in the room with a roommate. The facility provides areas for visitation within the hours of visitation and is willing to make arrangements for special request within reason.

Allegation: Staff are mishandling a resident while in care. Based on records reviewed and interviews conducted the facility, the department is unable to confirm that R1 has been mishandled. The records reviewed did not show any unusual marking's on R1 or any history of bruising or any other identifiers that would support mishandling of a resident. R1 has been a resident of the facility for seven years and has not made any complaint or allegation of being mishandled by the staff at this facility.


Exit interview conducted.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2