392701388-3-27-2026-27-AS-LKIG-DTEU8C-20260423152118

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 392701388
Report Date: 03/27/2026
Date Signed: 03/27/2026 02:25:39 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
11/09/2025 and conducted by Evaluator Kesha Lewis

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20251109215223

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:	01:30 PM
MET WITH:	Carolyn Appeal		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff neglect resulted in resident sustaining a knee laceration
Staff did not keep resident's authorized person informed about the resident's care

INVESTIGATION FINDINGS:

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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 interviews and documents reviewed including the residents death certificate there was no mention of a laceration on the residents’ knee. Nor did the facility have pictures of any such laceration. All interviewed stated they resident would scratch herself and based on medical records reviewed the resident was proscribed an anti-tech medication. 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)

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