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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015601219
Report Date: 12/11/2025
Date Signed: 12/11/2025 06:41:37 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/04/2025 and conducted by Evaluator David Doidge
COMPLAINT CONTROL NUMBER: 15-AS-20251204114249
FACILITY NAME:LAKE MERRITT CARE HOMEFACILITY NUMBER:
015601219
ADMINISTRATOR:MILLARE, MARIAFACILITY TYPE:
740
ADDRESS:576 VALLE VISTA AVENUETELEPHONE:
(510) 832-0442
CITY:OAKLANDSTATE: CAZIP CODE:
94610
CAPACITY:15CENSUS: 15DATE:
12/11/2025
UNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Licensee Marie MilareTIME COMPLETED:
07:00 PM
ALLEGATION(S):
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Staff does not prevent physical alteration between residents.
INVESTIGATION FINDINGS:
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On 12/12/2025 at 3:10 PM, Licensing Program Analysts (LPAs) David Doidge and Andrew Christy arrived unannounced to conduct the Initial 10 Day Complaint Investigation and deliver findings regarding the allegation above. LPAs met with Licensee Marie Milare and explained the purpose of the visit.

During the course of the investigation, LPAs spoke with Licensee Marie Milare. LPAs obtained and reviewed the Physician’s Report, Preappraisals, Appraisal Needs and Services, Functional Capability Assessment, and the Identification Page for four (4) residents. LPAs also obtained and review the facility’s LIC500and staff training.

Allegation: Staff does not prevent physical alteration between residents.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

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

DATE: 12/11/2025
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 15-AS-20251204114249
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: LAKE MERRITT CARE HOME
FACILITY NUMBER: 015601219
VISIT DATE: 12/11/2025
NARRATIVE
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Continued from LIC9099

Investigation Findings: It was reported to the department that a resident in the facility reported that they had been beaten several times in the past year by another resident. It was also reported that staff said they monitor the individual and break the fights up when they occur, but a resident did not feel that that was adequate. LPAs reviewed the facility’s staff schedule and saw that there is adequate staff to monitor all residents and meet the level of care and supervision needed for the residents. Licensee reported that staff are trained in altercation prevention and trained in how to mitigate and redirect behaviors. File reviewed showed that resents are getting their needs met, and that no resident has a level of aggression or behavior that staff cannot meet. Staff do monitor residents throughout the day and actively engage with residents. Staff step in as soon as possible to prevent physical altercations and redirect residents when voices rise, or resident behavior starts to escalade. Staff are trained to report all unusual incidents to the department. All residents are able to leave the facility unassisted, and no resident requires one-on-one care. LPAs observed that residents do get along, and the facility was found to be safe and well-maintained. Staff are responsive and attentive to residents. Altercations between residents may happen, but staff do their best to prevent escalation and would step in right away should a physical altercation break out. Staff have reported to such event occurring in the recent past.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated.

No deficiencies observed during visit.

Exit interview conducted and a copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: David Doidge
LICENSING EVALUATOR SIGNATURE:

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

DATE: 12/11/2025
LIC9099 (FAS) - (06/04)
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