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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 392700993
Report Date: 10/20/2025
Date Signed: 10/24/2025 02:08:11 PM

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
07/17/2025 and conducted by Evaluator Albert Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20250717093320
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: 155DATE:
10/20/2025
UNANNOUNCEDTIME BEGAN:
01:16 PM
MET WITH:Sunny S.TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff unlawfully evicted the residents
INVESTIGATION FINDINGS:
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LPA Albert Johnson made an unannounced visit to deliver complaint findings for the allegation listed above.

LPA interviewed Staff and Clients. As a result of the interviews and facility visits, LPA learned that the resident was smoking in the room while on oxygen this is an immediate health and safety risk to all residents in care. R1 was sent out to the ER to be treated for COVID. R1 did not return to the facility, R1 was discharged to a skilled nursing facility and required a higher level of care. An eviction letter was given to the resident. As a result of the need for a higher level of care R1 will be discharged to a facility that can meet R1's needs.
Unfounded
Estimated Days of Completion: 0
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
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-20250717093320
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: 10/20/2025
NARRATIVE
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R2 received multiple requested from the facility and corrective actions to stop drinking alcohol in the room along with smoking in the room. This is a safety risk regarding alcohol and fire to all residents in care. R2 moved out of the facility on September 11, 2025 and back to Sacramento, California.

As a result of this investigation, the department finds allegation to be (U) Unfounded - A finding that the complaint is Unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

An exit interview was conducted with Administrator/licensee and a copy of this report was provided to the licensee.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Albert Johnson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2