392701388-3-27-2026-27-AS-LKIG-DTEU7H-20260423151959

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701388
Report Date: 03/27/2026
Date Signed: 03/27/2026 02:21:20 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
01/14/2026 and conducted by Evaluator Kesha Lewis

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20260114165215

FACILITY NAME:	BALANCE ASSISTED LIVING AND MEMORY CARE		FACILITY NUMBER:	392701388
ADMINISTRATOR:	RACHELLE REYES		FACILITY TYPE:	740
ADDRESS:	1321 S. FAIRMONT AVENUE		TELEPHONE:	(209) 334-3436
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	136	CENSUS: 67	DATE:	03/27/2026
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Carolyn Appeal		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Resident sustained an unexplained injury while in care.
Staff did not ensure that resident's room is cleaned.
Staff did not notify resident's responsible party of an injury.
Staff are not meeting resident's hygiene needs.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 03/27/26. Licensing Program Analyst (LPA) Kesha Lewis and Licensing program manager (LPM) Liza King made an unannounced visit to this facility to deliver findings for the above allegations. LPA and LPM identified themselves upon arrival, stated the purpose of their visit, and asked to meet with the Designated Facility Administrator.

Based on LPA'S observation of the resident 1 and their room The resident was clean and hair their hair was done. R1'S room was clean and sanitary. . Therefore, this allegation is UNSUBSTANTIATED. A finding of unsubstantiated means the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted with Administrator, and a copy of this report was provided. Appeal rights and LIC 811 provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Kesha Lewis
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2026

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 1