015601283-4-17-2025-15-AS-KHOS-DGNNFK-20250514102541

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 015601283
Report Date: 04/17/2025
Date Signed: 04/17/2025 06:53:30 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/29/2024 and conducted by Evaluator Grace Luk

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20240829091101

FACILITY NAME:	PARKVIEW, THE		FACILITY NUMBER:	015601283
ADMINISTRATOR:	TIBON, AIREEN		FACILITY TYPE:	740
ADDRESS:	100 VALLEY AVE		TELEPHONE:	(925) 461-3042
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94566
CAPACITY:	123	CENSUS: 101	DATE:	04/17/2025
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Aireen Tibon, Executive Director		TIME COMPLETED:	07:05 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility did not issue a proper refund

INVESTIGATION FINDINGS:

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

On 4/17/2025 at 4:00PM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a complaint investigation and deliver findings in regards to the allegation above. LPA met with Executive Director, Aireen Tibon and explained the purpose of the visit.

During the course of investigation, LPA interviewed staff and complainant. LPA also obtained and reviewed admission agreement, care plan, incident report, email correspondence, and copy of the check. Interview with staff revealed that a check was issued to R1's family on 9/12/2024 and the check was cleared on 9/18/2024. S1 stated that R1 did not submit a 30 day notice to facility, but S2 had a discussion with R1's family and would reimburse R1 for the whole month.

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. Exit interview conducted. A copy of this report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Grace Luk
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025

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 1