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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 019200521
Report Date: 06/24/2022
Date Signed: 06/24/2022 03:08:56 PM

Unfounded


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
06/14/2022 and conducted by Evaluator Kelly Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20220614110708
FACILITY NAME:CREEKVIEW ASSISTED LIVINGFACILITY NUMBER:
019200521
ADMINISTRATOR:PATRICK D. MCELROYFACILITY TYPE:
740
ADDRESS:2900 STONERIDGE DRIVETELEPHONE:
(925) 353-5717
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY:136CENSUS: 68DATE:
06/24/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Patrick Mcelroy, AdminstratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility Staff financially abused a resident in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/24/2022 at 1PM Licensing Program Analyst (LPA) K. Nguyen, and Licensing Program Manger J. Fong (LPM) arrived unannounced to conduct investigation on the above allegations. LPA and LPM met with Assisted Living Administrator, Patrick Mcelroy, and explained the purpose of the visit.

It was alleged that a staff person had financially abused a resident. LPA KN and LPM JF reviewed randomly selected 10 resident files to review; reviewed the full staff roster, and interviewed R1 & Administrator. It was found that the alleged abuser is not a staff person of the facility. Therefore the allegation is Unfounded.

Per records review and interviews, the Department has investigated this complaint and has determined it to be Unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

An exit interview was conducted and a copy of this report was provided.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Kelly Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022
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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